An update on my vigil of pain

I can assure you that most doctors just want to practice Medicine. We do not receive training in business or medical insurance or Medicare in Med School; we learn what we need to practice Medicine. The regulatory environment in which you practice has strict rules and heavy penalties for not adhering to them, especially with Medicare and Medicaid but also with many private health plans. The doctors are forced to follow protocol, not because they are trying to make more money off of you but because this is how the system is set up. HMO's tend to be better about this (and I believe that is the model that will eventually be the national standard here) but even there, we must follow the rules and document care in a way that justifies the procedures we do. Why? Because if we don't then the business fails and everyone loses - patients and health care providers alike.
The problem I have is taking off for 2 visits when one will do it.
 
Believe it or not, doctors have the same problems when they go to see another doctor. It's insurance....
Definitely price shop for an MRI.
R
 
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I got lucky when I found my doctor. He's about my age and emigrated here from Greece back in the 1970s. He was a blue-collar guy who worked making iron fences during the summer. In Europe higher education is highly subsidized and costs practically nothing. His practice is a partnership that he owns with another doctor. Therefore he doesn't have the assembly line approach that other doctors are forced to follow. We have real conversations and he goes out of his way to explain things clearly and thoroughly. I sure hope he keeps practicing for a while. If he does retire I will look for another doctor with common sense who also owns his practice.

So SB I'd guess my suggestion would be to research and see if there is somebody near you whose circumstances are similar and can reduce some of the BS for you.
 
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@Silverbullet ,
I have no comment on medical systems or billing practices.

I just wanted to send all my best wishes with your upcoming procedures.
I hope you come out of it all with less pain and then can get back to doing more in your shop.
-brino
 
I can't make a comment regarding what your Medicare Insurance will pay vs. what you will need to pay. I believe that you will be charged 20% of the cost as a copay. I don't have Medicare but when I needed to get a CAT scan, if I went to the hospital radiology dept. to have it done the cost would have been over $4,000, a stand alone company that is 1-block from the hospital the total charge was $480. Even with the insurance I would have paid more in co-pay to the hospital than what the total charge was from the free standing practice. Both facilities are on the insurance companies "in-network" list. You MIGHT be able to get the hospital to accept the payment from Medicare as payment in full; but you need to look into that prior to going into the hospital and get it in writing. Good luck and get well
Oh I'm familiar with the twenty percent payment . I'm still paying from 2009 on the copayments from my times that year. But what you don't know I've been disabled since 1979 , our only income is my SS disability . And my wife made $8,000 last year part time cause she's got worn out knees and back pain too. So now tell me can you live and pay your bills with that income. In a good summer season I can make a couple thousand selling used equipment. Lawnmowers and small engines. So tell me how good I have it how great it is to be livin on SS.
I'm not complaining just saying, I tell the drs I'm unable to pay the deductibles , many except the payment and don't send the bills. Others I just throw away. Can't get blood from stone . There's no bank account or hidden funds , our cking account is sum total of life.
 
Silverbullet, sorry to hear about your situation. If you're a vet then the VA is the first place I would go. If not, and if you are not a Medicaid member then you should speak to a social worker so they can assist you in enrolling. Some social workers, at least the ones that aren't burnt out, can be really helpful in helping you deal with business offices, too.

I pray Trump doesn't have his way with Medicaid and Medicare.
 
Yes, definitely look into your states medicaid. Many think its the same thing as medicare. There is a big difference, in most cases, it is only a $1 copay. Good luck finding Doctors that will accept it, but if you are an existing patient, they will have a harder time saying they do not want to see you again.

I agree with Mikey, If you are a Veteran, go directly to the VA, and do not pass go. They get a bad rap, some deserved, most not.

I also have an interstim, and often think it was a mistake.
 
I was not talking anything political , I was complaining about the waste of time and money trying to get a simple procedure and an mri done on one visit to a hospital. It's no fun trying to get to anyplace when every bump in the road cause screaming pain. It's not like I can hop in a car drive over and sit and wait. The entire time I'm upright it gets worse I don't care one DERN bit about there billing and the ways the system uses the lawyers , politicians, and drug companies. There has to be leeway and flexibility . You can bet your butt if I was John q senator those tests would be done the same day . The removal is a local in the lower back about two inches or less . Not like ill be knocked out. Every time I need to go to a Dr or test my daughter looses a days pay. The pains to horrific for me to transfer to drive and back in the chair six times .
 
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