A Physician’s New Reality: Patients A...

A Physician’s New Reality: Patients Ask Me to Break the Law

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Since: Sep 12

Hilliard, OH

#1 Nov 24, 2012
Obama won, Obamacare is the law, and, as my wife says, I will just have to learn to dance to a new song.

Now, don’t get me wrong, Obamacare is awful. Forget all the “free stuff” it provides. Children covered on their parents’ plan until 26 years of age? A scam, making young adults — excuse me, children — pay for complete, comprehensive health insurance when all they need and should pay for is major catastrophe insurance. Then there is the “annual ” or “preventative” exam, which according to Obamacare is “free.”

You gotta love this stuff. I wish I had the chutzpah of the people who wrote Obamacare. What they did not tell you, and I am, is that it covers absolutely nothing more than the bare minimum.

I have now posted a notice in my office and each exam room stating exactly what Obamacare will cover for those yearly visits. Remember Obama promised this as a free exam — no co-pay, no deductible, no charge. That’s fine and dandy if you are healthy and have no complaints. However, we are obligated by law to code specifically for the reason of the visit. An annual exam is one specific code; you can not mix this with another code, say, for rectal bleeding. This annual visit covers the exam and “discussion about the status of previously diagnosed stable conditions.” That’s the exact wording under that code — insurance will not cover any new ailment under that code.

If you are here for that annual exam, you will not be covered if you want to discuss any new ailment or unstable condition. I cannot bait and switch to another code — that’s illegal. We, the physicians, are audited all the time and can lose our license for insurance fraud.

You, the patient, will then have to make a decision.

Do you want your “free” yearly exam, or do you want to pay for a visit which is coded for a particular, new problem? You can have my “free” exam if you only discuss what Obamacare wants me to discuss.

This happened to me personally, as a patient, when I went for my physical. It is the law. If you are complaining of a new problem, then you have to reschedule, since Obamacare is very clear as to what is covered and what is not. Obamacare — intentionally — makes it as difficult to be seen and taken care of as possible.

Patients can be very tricky. I have had patients make an “annual” exam, only to want to discuss and be treated for another ailment. I can’t do it.

I can hear the complaints from you guys already — I become the bad guy.“Why don’t you just take care of the problem, and not bill out any different code? You’re a rich doctor, and we are entitled to free stuff.”

It doesn’t work that way. First, doctors are not rich and, like most of you, actually work terribly hard for a living. Second, Obamacare is the law — and as I said earlier, we are audited all the time now.

Also — I don’t ask for free gas when I go to the gas station, or ask for free food from the supermarket. Additionally, Obamacare has a 23% cut in Medicare reimbursement to doctors and hospitals.

These lower payments won’t cover the cost of staying in practice to take care of the patient.

Private doctors are becoming a thing of the past. By 2014, less than 25% of physicians will be in private medicine. Obama was right in stating you can keep your doctor if you want to — the problem is he or she will rarely be available.

Since: Sep 12

Hilliard, OH

#2 Nov 24, 2012
On top of all of that, doctors will be obligated — that’s right, obligated — to talk to you about things you may have no interest or need to talk about.

You may just want to have a pap smear or check your cholesterol. However, I am now mandated by the government to talk to you about your weight, exercise, family life, smoking, sexual abuse(!), and even to ask if you wear seat belts. And I am mandated to record your answers.

I am a physician. But I need to tell you to wear a seat belt and then record your answer.

I have received interesting responses from my patients since I put up the notice. Almost all are supportive and totally understand. The very few who complain? The same patients who always ask for free samples, who always complain that we do not validate parking. These are also the same patients who call my office and ask for free samples even when they are not even being seen.

Obamacare and its 2,000-plus pages are here to stay. I will still give my patients 100% of my time, energy, and knowledge. I still love being a doctor — my patients’ doctor. I will, however, abide by the law and follow it to the letter. I will have to learn this new dance.“Free” has its price.
http://pjmedia.com/blog/a-physicians-new-real...

Since: Sep 12

Hilliard, OH

#3 Nov 24, 2012
Peter Weiss M.D., F.A.C.O.G., is Director and Founder of The Rodeo Drive Women's Health Center. He is also Assistant Clinical Professor of OB/GYN at The David Geffen School of Medicine at UCLA. He was health care adviser to John McCain's presidential campaign. Dr Weiss is an Attending physician at Cedars Sinai and St Johns Health Centers
Mike

Athens, OH

#4 Nov 24, 2012
Here I opened this page thinking The patients was asking you for pills lol!!!

Bro I got out of the pen for asking for pills myself so I think you can see why this post got me to open it lol!!!
Spookstillhere f trolls

Detroit, MI

#5 Nov 24, 2012
Mike wrote:
Here I opened this page thinking The patients was asking you for pills lol!!!
Bro I got out of the pen for asking for pills myself so I think you can see why this post got me to open it lol!!!
You need to move to Netherlands if you want drugs.
Mike

Athens, OH

#6 Nov 24, 2012
Spookstillhere f trolls wrote:
<quoted text>
You need to move to Netherlands if you want drugs.
Now Can I Buy The Pills In The Netherlands OTC?

My days of smoking that other crap are just over
Spookstillhere f trolls

Detroit, MI

#7 Nov 24, 2012
Mike wrote:
<quoted text>
Now Can I Buy The Pills In The Netherlands OTC?
My days of smoking that other crap are just over
Pretty much. Not a very strong drug but darvacet is over the counter in most of Europe.
Spookstillhere f trolls

Detroit, MI

#8 Nov 24, 2012
Mike wrote:
<quoted text>
Now Can I Buy The Pills In The Netherlands OTC?
My days of smoking that other crap are just over
Stronger narcotics are available without prescription for recreational use in Amsterdam.

“Don't trust the internet!”

Since: Jan 12

Location hidden

#9 Nov 24, 2012
This doc is writing about things that allegedly happened under regs that haven't yet gone into effect so long as I can tell. But, further, they are no different than the kinds of coding restrictions under any existing insurance company--they all use the coding developed by the govt for Medicare/Medicaid.

Specifying things that must be covered in an annual visit is a growing trend--around since before Obama began his run for office. Medicaid has long required that children be tested for lead, as an example--because undetected lead exposure was a problem in the Medicaid population.

But the one code per visit requirement is nothing new under Obamacare. And yes, there are times when a doctor/patient faces a choice about whether to write a scrip for the strep throat that happens concurrent with the scheduled annual exam or to make the patient come back tomorrow to be seen for that and bill for two visits under separate codes. In my experience such annual visits are among the more highly reimbursed office codes--as they are expected to take longer and be more thorough.

Frankly it sounds to me like the doc is trying to justify regularly calling patients back for a second visit--with a population (Rodeo Drive) that can likely afford the copay for a sick visit.

Since: Sep 12

Hilliard, OH

#10 Nov 24, 2012
FKA Reader wrote:
This doc is writing about things that allegedly happened under regs that haven't yet gone into effect so long as I can tell. But, further, they are no different than the kinds of coding restrictions under any existing insurance company--they all use the coding developed by the govt for Medicare/Medicaid.
Specifying things that must be covered in an annual visit is a growing trend--around since before Obama began his run for office. Medicaid has long required that children be tested for lead, as an example--because undetected lead exposure was a problem in the Medicaid population.
But the one code per visit requirement is nothing new under Obamacare. And yes, there are times when a doctor/patient faces a choice about whether to write a scrip for the strep throat that happens concurrent with the scheduled annual exam or to make the patient come back tomorrow to be seen for that and bill for two visits under separate codes. In my experience such annual visits are among the more highly reimbursed office codes--as they are expected to take longer and be more thorough.
Frankly it sounds to me like the doc is trying to justify regularly calling patients back for a second visit--with a population (Rodeo Drive) that can likely afford the copay for a sick visit.
And there we have it...the class warfare card played by Reader. I'm sure you have the race card up your sleeve, too.
Wait what

Dublin, OH

#11 Nov 24, 2012
FKA Reader wrote:
This doc is writing about things that allegedly happened under regs that haven't yet gone into effect so long as I can tell. But, further, they are no different than the kinds of coding restrictions under any existing insurance company--they all use the coding developed by the govt for Medicare/Medicaid.
Specifying things that must be covered in an annual visit is a growing trend--around since before Obama began his run for office. Medicaid has long required that children be tested for lead, as an example--because undetected lead exposure was a problem in the Medicaid population.
But the one code per visit requirement is nothing new under Obamacare. And yes, there are times when a doctor/patient faces a choice about whether to write a scrip for the strep throat that happens concurrent with the scheduled annual exam or to make the patient come back tomorrow to be seen for that and bill for two visits under separate codes. In my experience such annual visits are among the more highly reimbursed office codes--as they are expected to take longer and be more thorough.
Frankly it sounds to me like the doc is trying to justify regularly calling patients back for a second visit--with a population (Rodeo Drive) that can likely afford the copay for a sick visit.
I believe you get two dx codes. And the seat belt question is new, as I got that one too this year for my annual, and really, if I answered "no" what does that mean? My license plate will be flagged?

Because George posted from a biased source, I did some digging. The doctor shares the same thoughts as others who don't practice on Rodeo Drive and whose political affiliation remains unknown.
Karl

Medina, OH

#12 Nov 24, 2012
Cleavon Little wrote:
<quoted text>And there we have it...the class warfare card played by Reader. I'm sure you have the race card up your sleeve, too.
AIDS was a US governmnet plot to kill the blacks/poor/insert other oppressed group of the month

/sarc/reader
Wait what

Dublin, OH

#13 Nov 24, 2012
FKA Reader wrote:
This doc is writing about things that allegedly happened under regs that haven't yet gone into effect so long as I can tell. But, further, they are no different than the kinds of coding restrictions under any existing insurance company--they all use the coding developed by the govt for Medicare/Medicaid.
Specifying things that must be covered in an annual visit is a growing trend--around since before Obama began his run for office. Medicaid has long required that children be tested for lead, as an example--because undetected lead exposure was a problem in the Medicaid population.
But the one code per visit requirement is nothing new under Obamacare. And yes, there are times when a doctor/patient faces a choice about whether to write a scrip for the strep throat that happens concurrent with the scheduled annual exam or to make the patient come back tomorrow to be seen for that and bill for two visits under separate codes. In my experience such annual visits are among the more highly reimbursed office codes--as they are expected to take longer and be more thorough.
Frankly it sounds to me like the doc is trying to justify regularly calling patients back for a second visit--with a population (Rodeo Drive) that can likely afford the copay for a sick visit.
Remember that under Obamacare, hospitals are fined for bounceback Medicare patients. It's a very common thing, bouncebacks, for the older folks. I wonder if it's an attitude like yours - the last sentence - that precluded someone writing this regulation into the healthcare bill?
Wait what

Dublin, OH

#14 Nov 24, 2012
Sorry, not precluded. Wrong word.
Wait what

Dublin, OH

#15 Nov 24, 2012
The author should have mentioned that under the new law, getting ibuprofen with your FSA funds requires a script - and that requires an office visit. If you're on a high deductible plan and your negotiated office visit rate is, say,$80, you would have to buy a whole lot of OTC stuff at once just to break even.

Let's not forget the limit of saving for health expenses to $2500 this year, either.

Oh, sorry, whining again. Sorry, more struggles for the working class in the name of being a compassionate Democrat is GREAT!/s
Wait what

Dublin, OH

#16 Nov 24, 2012
Doctors in shortage state cite consequences of Medicaid expansion

http://www.ama-assn.org/amednews/2012/11/05/g...

Ohio faces filling physician shortages in future

http://www.daytondailynews.com/news/news/fill...
Liberal

United States

#17 Nov 24, 2012
Me liberal
Me not realize affect Obamacare have on everything
Me vote for Obama anyway
notlocal

AOL

#18 Nov 24, 2012
FKA Reader wrote:
This doc is writing about things that allegedly happened under regs that haven't yet gone into effect so long as I can tell. But, further, they are no different than the kinds of coding restrictions under any existing insurance company--they all use the coding developed by the govt for Medicare/Medicaid.
Specifying things that must be covered in an annual visit is a growing trend--around since before Obama began his run for office. Medicaid has long required that children be tested for lead, as an example--because undetected lead exposure was a problem in the Medicaid population.
But the one code per visit requirement is nothing new under Obamacare. And yes, there are times when a doctor/patient faces a choice about whether to write a scrip for the strep throat that happens concurrent with the scheduled annual exam or to make the patient come back tomorrow to be seen for that and bill for two visits under separate codes. In my experience such annual visits are among the more highly reimbursed office codes--as they are expected to take longer and be more thorough.
Frankly it sounds to me like the doc is trying to justify regularly calling patients back for a second visit--with a population (Rodeo Drive) that can likely afford the copay for a sick visit.
You must have never had anything but government provided medical coverage. No private insurance has these kinds of restrictions or questions and I don't have to limit, nor does my doctor, what we discuss or what she prescribes in any visit.

Afford the co-pay???????? You've never paid a co-pay??? Good grief. No wonder the economy is barely breathing.

See if you can weedle Uncle Sam (Lord, does he even exist after Obama?) Get you a free course in medical billing. Then you might have some knowledge of coding. At present, you don't.
Wait what

Dublin, OH

#19 Nov 24, 2012
notlocal wrote:
<quoted text>
You must have never had anything but government provided medical coverage. No private insurance has these kinds of restrictions or questions and I don't have to limit, nor does my doctor, what we discuss or what she prescribes in any visit.
Afford the co-pay???????? You've never paid a co-pay??? Good grief. No wonder the economy is barely breathing.
See if you can weedle Uncle Sam (Lord, does he even exist after Obama?) Get you a free course in medical billing. Then you might have some knowledge of coding. At present, you don't.
That's not true. I have private insurance, I do have the restrictions, and I did get the seat belt question for my annual physical.

I'd be surprised if, at your annual visit, your doctor was free to diagnose and treat multiple ailments.
notlocal

AOL

#20 Nov 24, 2012
Wait what wrote:
<quoted text>
I believe you get two dx codes. And the seat belt question is new, as I got that one too this year for my annual, and really, if I answered "no" what does that mean? My license plate will be flagged?
Because George posted from a biased source, I did some digging. The doctor shares the same thoughts as others who don't practice on Rodeo Drive and whose political affiliation remains unknown.
Oh, one of my nieces is an OBG/YN surgeon in Atlanta. She specializes in high risk pregnancies. She now reads off a list of questions to her patients and tells them "This is becasue Obama wants all of your personal health information on file with the government for anyone who wants to look at it, and by the way, this time is going to cut short our visit."
Of course, she gives them the time and best care she can, but also, she is a staunch Christian and ready to walk away rather than breech her personal moral beliefs.
I have not run into the 'list' yet. I don't want my medical records publically available to be passed from agency to agency. Not sure what I'll do other than stay healthy.

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