OK, that is fair. But, when tendinitis is found as a result of a regular physical, we have to pay more for a co-pay. As in the same mammogram that is covered 100% for a preventable care visit is only covered at 85% because I have already had breast cancer, but in the opposite breast. In other words, I am getting screwed because I have been sick in the past. Thievery is accomplished at every level of medical care.
Self-pay office visits cost over 100 dollars each and that does not include labs, shots, meds and what-all. Fifty thousand people uninsured and this joker wants a co-pay-free visit.
all valid comments reflecting the screwed up beast we call healthcare. this visit was definitely not a physical, so to code it that way would be insurance fraud. but emmy, i hear what you're saying. I have no idea why insurance covers one thing 100% and another thing less. I'm sure it has something to do with their bottom line as it all does. (so cynical!) the co-pay is a just a tiny piece of the whole cost equation as Lynda points out. if you can't afford your co-pay, tell me that. I have waived many co-pays and entire visits for people with financial hardship. BUT, if i don't document that properly then i am comitting medicare fraud by accepting less of a payment then a medicare patient would have to pay. very tricky waters to navigate... thank you for reading and commenting ladies.
I understand that I'm only being asked to $52 for what started out as a $615 visit. But the reality is this, I am only getting the yearly mammogram. This is not a mammogram because I think there might be a problem. The woman that sits in the cube next to me goes to the same specialist and gets the same tests because she carries the BRCA 2 gene, but has never actually had breast cancer. Her visit is paid as preventative care and mine are not, only because I have had breast cancer in the past. I would not even consider asking my doctor to mis-document the visit, nor would I ask her to waive the co-pay. She would be in violation of the contract she signed with my insurance company. But I have rescheduled appointments when money is tight. I just resent the injustice of having to pay differently for the same service.
OK, that is fair. But, when tendinitis is found as a result of a regular physical, we have to pay more for a co-pay. As in the same mammogram that is covered 100% for a preventable care visit is only covered at 85% because I have already had breast cancer, but in the opposite breast. In other words, I am getting screwed because I have been sick in the past. Thievery is accomplished at every level of medical care.
ReplyDeleteWow. How big was that co-pay anyway ?~!
ReplyDeleteSelf-pay office visits cost over 100 dollars each and that does not include labs, shots, meds and what-all. Fifty thousand people uninsured and this joker wants a co-pay-free visit.
Maybe this person can't afford the co-pay. Lets not judge a person with out all the facts.Better yet lets not judge at all.
ReplyDeleteall valid comments reflecting the screwed up beast we call healthcare. this visit was definitely not a physical, so to code it that way would be insurance fraud. but emmy, i hear what you're saying. I have no idea why insurance covers one thing 100% and another thing less. I'm sure it has something to do with their bottom line as it all does. (so cynical!) the co-pay is a just a tiny piece of the whole cost equation as Lynda points out. if you can't afford your co-pay, tell me that. I have waived many co-pays and entire visits for people with financial hardship. BUT, if i don't document that properly then i am comitting medicare fraud by accepting less of a payment then a medicare patient would have to pay. very tricky waters to navigate... thank you for reading and commenting ladies.
ReplyDeleteI understand that I'm only being asked to $52 for what started out as a $615 visit. But the reality is this, I am only getting the yearly mammogram. This is not a mammogram because I think there might be a problem. The woman that sits in the cube next to me goes to the same specialist and gets the same tests because she carries the BRCA 2 gene, but has never actually had breast cancer. Her visit is paid as preventative care and mine are not, only because I have had breast cancer in the past. I would not even consider asking my doctor to mis-document the visit, nor would I ask her to waive the co-pay. She would be in violation of the contract she signed with my insurance company. But I have rescheduled appointments when money is tight. I just resent the injustice of having to pay differently for the same service.
ReplyDeleteOhh...and I do recognize that it is the insurance company, not the doctor who is being unfair.
ReplyDelete