Text 12340, 55 rader
Skriven 2010-11-19 13:36:05 av Richard Webb (1:116/901.0)
  Kommentar till text 12322 av Bob Ackley (1:300/3)
Ärende: Credit/debit
====================
HI Bob,

On Thu 2038-Nov-18 17:34, Bob Ackley (1:300/3) wrote to Richard Webb:

 RW> Another thing that insurers used to do, back in the early
 RW> '80's anyway when I was more acquainted with the industry
 RW> from the sales side and other places is this:

 RW> If in a locale, let's say Omaha/council Bluffs, most
 RW> providers charge $x for a procedure, but your care provider
 RW> charge $x+50.  Even though they submit the bill to your
 RW> insurance provider for $x+50 they'll only get reimbursed for $x minus
 RW> your copay of course.  sO, when "reasonable and customary" is
 RW> determined consistently for a locale providers often bump the price
 RW> to get "reasonable and customary increased.

BA> Funny thing you brought up Omaha/Council Bluffs.  FYI, exactly the
BA> same diagnosis, treated with exactly the same procedure and/or
BA> exactly the same medication is reimbursed at a higher rate in Omaha
BA> than in Council Bluffs,  which is IN the Omaha metro area and is
BA> separated from Omaha by about a  hundred, maybe a hundred and fifty
BA> yards of filthy brown water.  But Medicare's reimbursement rate for
BA> Nebraska is higher than the rate for Iowa.  Idiot bureaucrats
BA> and congresscrooks.

I knew it went one way or t'other out there, but couldn't
remember which.  Way way back when I sold accident health
insurance out in western Iowa.  I knew you'd know <grin>.
Just illustrates my point doesn't it?

BA> While I'm ranting about Medicare - which I was forced to enroll in
BA> (if I didn't my
BA> military Tricare coverage would end) - is going to reduce its
BA> reimbursement rates 
BA> to providers by about 23 percent next month.  Really makes providers
BA> want to sign
BA> up for that program, doesn't it - which is undoubtedly why primary
BA> care providers
BA> are quietly droppping out of the Medicare system (by not accepting
BA> any new Medicare
BA> patients).,

YEah, and MEdicaid is even worse.  FOr a long time over in
eastern Iowa there were docs who'd almost beg you to get
sick enough to have to go to er, because they really didn't
want any new medicaid patients.  I had a few friends on it
at the time, and they all b*tched and moaned.  I told every
one of them that were I a health care provider I woulnd't
put up with all that bull either.  FOrce me to hire another
pencil pusher just to deal with the bureaucracy.  NO thanks!

Regards,
           Richard
--- timEd 1.10.y2k+
 * Origin:  (1:116/901)