notlocal

AOL

#21 Nov 24, 2012
Wait what wrote:
<quoted text>
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.
Well then, be surprised. My last semi-annual was on Sept.11, 2012. No questions and we did discuss a new complaint I had and she ordered new diganostic tests for it. She also prescribed my meds for the next year and changed one or two. Not that I take a dozen. And that was on my husband's company provided health insurance with a fairly well known insurer.

Now of course, that was before the election. Did they begin this other on Nov. 7th?
notlocal

AOL

#22 Nov 24, 2012
Wait what wrote:
<quoted text>
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?
That's true. They are fined for readmissions.
Wait what

Dublin, OH

#23 Nov 24, 2012
notlocal wrote:
<quoted text>
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.
Hmmm, I don't think I've ever heard a provider put it quite like that.

“Don't trust the internet!”

Since: Jan 12

Location hidden

#24 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.
Dx codes and CPT codes are different.

Seat belt question doesn't seem like a horrific reminder, given what we know about their ability to prevent or lessen serious injury. Presumably a doc who finds out that a patient is not using their seatbelt would provide information that would help motivate them to do so. These things change over time, along with recommended schedules for mammography, colonoscopy and the like. There are folks who evaluate risk, impact of testing (or whatever) on risk and outcomes and come up with best practice guidelines.

“Don't trust the internet!”

Since: Jan 12

Location hidden

#25 Nov 24, 2012
Wait what wrote:
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
I get a scrip for extra strength ibuprofen--which saves me some bucks over purchasing an equivalent amount (taking more pills at the same time) OTC. That is the sort of scrip that the doc is generally willing to provide a refill for based on a phone call. And since I am in at least annually for other things as a rule, it is not difficult to get the initial scrip.

If I was in the situation you describe ($80 copay--a number I presumed you plucked from thin air--and no other medical needs), and only needed the ibuprofen sporadically, I would elect to just buy the generic on sale. Somehow, this doesn't strike me as a deal-breaker.

“Don't trust the internet!”

Since: Jan 12

Location hidden

#26 Nov 24, 2012
Wait what wrote:
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...
The implication of course being that the best response to a physicial shortage is to make certain that everyone cannot afford to go see a doctor?
Karl

Medina, OH

#27 Nov 24, 2012
FKA Reader wrote:
<quoted text>
The implication of course being that the best response to a physicial shortage is to make certain that everyone cannot afford to go see a doctor?
Expanding the supply of physicians ain't gonna happen, until the Medicare cartel that controls it ends.

“Don't trust the internet!”

Since: Jan 12

Location hidden

#28 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.
In fact I probably have more experience with medical billing than you suppose.

The fact that a doc has never limited what you discuss during a visit is merely evidence that this is pretty much a non-issue. If someone were to come in for a routine follow-up visit and wanted to turn it into a complete physical, they might be asked to reschedule--as physicals typically take more time. But I have never known a doctor who discovered something during the course of a physical to refuse treatment during the visit, unless we are talking referral for further diagnostic work and the like.

However, there are several codes that typically apply to office visits that refer to a combination of time/intensity of services. Your copay is most likely identical for each one, so unless you follow your insurer's information pretty closely, you probably are unaware of the difference.

The doc in question seems to fear that patients will try to avoid their copay by scheduling a "problem" visit as an annual physical. Like most fears of medical fraud by patients, it is difficult to envision. And the reality is, they could only pull the stunt once a year. So--the doc should insist that they get the full treatment, or else simply treat the problem, pay the copay, and come back another time for their complete physical (with no copay).

In short--someone's trying to make a mountain out of a molehill.

I used to know a nurse who believed that a good bit of first aid consisted in good prevention. My favorite bit of guidance along those lines was, "people do really stupid things when they are angry or tired."

“Don't trust the internet!”

Since: Jan 12

Location hidden

#29 Nov 24, 2012
Karl wrote:
<quoted text>
Expanding the supply of physicians ain't gonna happen, until the Medicare cartel that controls it ends.
The Medicare cartel?

“Don't trust the internet!”

Since: Jan 12

Location hidden

#30 Nov 24, 2012
notlocal wrote:
<quoted text>
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.
I hope someone sues her for malpractice. Telling your patients politically motivated lies certainly seems to fall somewhere along that continuum.

“Don't trust the internet!”

Since: Jan 12

Location hidden

#31 Nov 24, 2012
notlocal wrote:
<quoted text>
That's true. They are fined for readmissions.
The reason is because readmissions are so frequently a result of premature discharge.
Wait what

Dublin, OH

#32 Nov 24, 2012
FKA Reader wrote:
<quoted text>
I get a scrip for extra strength ibuprofen--which saves me some bucks over purchasing an equivalent amount (taking more pills at the same time) OTC. That is the sort of scrip that the doc is generally willing to provide a refill for based on a phone call. And since I am in at least annually for other things as a rule, it is not difficult to get the initial scrip.
If I was in the situation you describe ($80 copay--a number I presumed you plucked from thin air--and no other medical needs), and only needed the ibuprofen sporadically, I would elect to just buy the generic on sale. Somehow, this doesn't strike me as a deal-breaker.
Gawd.

It's February. I haven't been to the doctor yet, and I have a $2000 deductible. The lowest amount my physician charges for an office visit is $80 (they run $80 -$120, the negotiated rates). Due to time constraints, the practice does not provide prescriptions for OTC needs so you must make an appointment.(BTW, this is all in accordance with the new IRS laws.)

The FSA was designed to be able to put money aside pre-tax so that you can purchase your OTC needs (let's say, gauze) or whatever using that money. It was designed to help counter high medical bills. Until this year with the reform, you could just use your card and go to the store and get whatever you needed. Now there are limitations on what qualifies as well as the script requirement.

Give it up, Reader - the new rules are lousy for people who have a lot of medical bills and work full-time making more than minimum wage. That includes reducing the amount you can put pre-tax into a HSA, effective in 2013.

Bully for you on your extra strength ibuprofen. It can do quite a number on your gastro system, which is why I don't use it. Doctor's orders.
Wait what

Dublin, OH

#33 Nov 24, 2012
FKA Reader wrote:
<quoted text>
The reason is because readmissions are so frequently a result of premature discharge.
Maybe you should stick to something you know, Reader. This ain't it.

Since: Sep 12

Hilliard, OH

#34 Nov 24, 2012
FKA Reader wrote:
<quoted text>
The reason is because readmissions are so frequently a result of premature discharge.
We're not interested in why you were divorced, dear.
Wait what

Dublin, OH

#35 Nov 24, 2012
FKA Reader wrote:
<quoted text>
The reason is because readmissions are so frequently a result of premature discharge.
That kind of puts a wrench into government-managed healthcare, then, since Medicaid patients blow the readmission rate out of the water.
notlocal

AOL

#36 Nov 24, 2012
Wait what wrote:
<quoted text>
Hmmm, I don't think I've ever heard a provider put it quite like that.
Her sister, who is an RN, told me about it. I don't doubt it for a minute.
The RN niece, she got a doctors privileges revoked! Went up against him and the board.
They're both like their mother, always for the underdog and strong women. Little bit of my hardheadness in there too.
I thank God daily they are not working in the same hospital.:-)
BTW, when the HR person was explaining the health and life insurance to the employees at my husband's company, she kept adding "And you can thank Obama for this."
I am against the invasion of privacy. I really do not intend to answer the questions.
notlocal

AOL

#37 Nov 24, 2012
Cleavon Little wrote:
<quoted text>We're not interested in why you were divorced, dear.
LMAO! Good one, George.
Wait what

Dublin, OH

#38 Nov 24, 2012
FKA Reader wrote:
<quoted text>
Dx codes and CPT codes are different.
Seat belt question doesn't seem like a horrific reminder, given what we know about their ability to prevent or lessen serious injury. Presumably a doc who finds out that a patient is not using their seatbelt would provide information that would help motivate them to do so. These things change over time, along with recommended schedules for mammography, colonoscopy and the like. There are folks who evaluate risk, impact of testing (or whatever) on risk and outcomes and come up with best practice guidelines.
I had two close family members die in a car accident for lack of seatbelt use, so I'm quite familiar with the results of no seatbelts. Of course, since it wouldn't be a horrific reminder to you that's all that matters.
notlocal

AOL

#39 Nov 24, 2012
FKA Reader wrote:
<quoted text>
I hope someone sues her for malpractice. Telling your patients politically motivated lies certainly seems to fall somewhere along that continuum.
She's not telling lies, and oh, what fun we'd have with a malpractice suit for that.

You're an idiot.
notlocal

AOL

#40 Nov 24, 2012
Wait what wrote:
<quoted text>
That kind of puts a wrench into government-managed healthcare, then, since Medicaid patients blow the readmission rate out of the water.
As I said in an earlier post, it appears medicaid patients see doctors and require many more tests than a regular working person with private insurance. Crazy. I don't know if the government is CTA from lawsuits, or the unemployed are bored or hypochondriacs.

You know it's a 'can't win' for the hospitals. The insurer is pushing them to discharge as quickly as possible, they can't follow up on the patient's homecare, yet if they re-admit, Obama fines them. And if they don't re-admit, they are sued by the patient or the patient's family.

No wonder so many docs are getting out of the business. This has got to go down as the most poorly written legislation in history. And completely partisan.

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