191–200 of 372 posts
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Is insurance the villain on this one of the hospital charging insurance 26k for an MRI?
Possibly all of the above. An MRI shouldn't cost $26k, even with contrast, and at a hospital. If this was non-emergency, it should have been pre-cleared with insurance per their policy.
You could fly to New Zealand, have a scan on a state of the art machine, get a good report, have 3 weeks holiday and fly home. You’d have heaps of money left over.
My spouse is a physician, and "patient messages" (aka "non-face-to-face" encounters) usually aren't reimbursed by insurance. Having a friendly online conversation with a patient doesn't generate the "RVUs" they need (contractually!), so time spent messaging is time taken out of their personal day on top of their regular workload. Responding to messages can also just be very difficult and time consuming. Maybe you ask…
My biggest gripe here is that if the doctor answers me outside office hours, an additional "emergency / inconvenience fee" is added. Like, I can't control when you answer, and I didn't choose it. If I send in something during daytime and you didn't get to it, answer me the next day, then. Or make it a choice that I want a prioritized answer so at least I decide. It's just bonkers.
Here's American health care: • I needed refills for two prescriptions that I've been taking for years. This time, for opaque reasons, I needed to talk to a doctor first. • Fine, but I couldn't accommodate an in-person check-in. I chose a "video visit" that, due to logistics, I had to do while away from home. Because they were a half-hour late, I was effectively forced to do this from the couch of a Costco floor displ…
One Medical charges $9/month (through Amazon), all video visits are free (if you click the proper link), and I've had multiple prescriptions renewed that way. Three times waited less than a minute, longest wait was 15 minutes, and the app will call you back if you wish so you don't have to keep the app open.
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>You have no idea what this person was being seen for. I feel fairly comfortable assuming that they were being seen for a minor-to-moderate burn.
That was the treatment received, but perhaps they were referred to the ER by EMS for smoke inhalation. I don't know either, but the broader point is that people are referred to the ED by medical professionals for seemingly minor issues all the time, and that the incentives are all lined up to treat stupid shit in the ER rather than have someone tell them to go somewhere that makes more sense.
Isn't it CYA for any EMS to recommend you visiting the hospital, so they just say it to anyone. That allows them to later say that you failed to follow recommended advice.
My spouse is a physician, and "patient messages" (aka "non-face-to-face" encounters) usually aren't reimbursed by insurance. Having a friendly online conversation with a patient doesn't generate the "RVUs" they need (contractually!), so time spent messaging is time taken out of their personal day on top of their regular workload. Responding to messages can also just be very difficult and time consuming. Maybe you ask…
Getting a doctor to respond through our digital messaging platform is practically impossible. Unless you're extremely persistent and specifically ask for the doctor's input (and send 3-4 messages back and forth with the nurse, whose responses are less relevant than a google search), it's impossible. I wonder if charging for these messages will make doctors more likely to respond. I wouldn't mind a modest copay for th…
Physicians won't see a dime of that money unless it's through RVUs and even then it's marginal at best. The real money is in procedures.
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I mean I'm not sure that you shouldn't be charged ER prices for taking an over-the-counter-treatable injury to the ER. You probably shouldn't be charged 4000 for going to the ER, but just because you didn't actually need to go to the ER doesn't mean you didn't consume ER resources (the 24/7 staffing, the intake logistics, the trauma expertise, etc). Probably the biggest surprise there is that a doctor saw you at all…
You have no idea what this person was being seen for. It is fairly common for someone to be advised to seek emergency treatment out of precaution to ensure that a minor symptom is not indicative of a severe problem. For example dizziness can be a completely nothing-burger inner ear problem treated with a bunch of motions from youtube, or it can be a stroke. The ER exists to make that distinction. Part of all those lo…
Insurance did try to deny coverage, but fortunately I appealed and won.
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> I wonder if charging for these messages will make doctors more likely to respond. Why would it do that? If they get money for messages sent (rather than messages sent by doctors) then some flunky can send a message and you can still be billed. Given how this sounds like a profit center, and doctors are cost centers (imagine if they needed to send more messages... now they have to pay more doctors!), I figure physic…
Interesting point. That could make for some awkward conversations if the patient thinks messages were coming from their doctor but then the director had no memory of the messages. It would also seem fraudulent to have messages signed by the doctor when it wasn’t actually sent by that doctor. I think it’s much more likely that doctors will end up sending AI-autocompleted messages that take very little time to complete…
The standard will evolve to something like clinic staff sending the messages which will be overseen/supervised by a medical doctor (who won't be involved in composing the messages or spend any time looking at them before or after they are sent). We'll see trials where the doctor who was supposed to be keeping an eye on the messages wasn't, and some flunky kills a patient by suggesting that drinking used engine oil will cure the sniffles. Keep in mind that the messages can be sent from anywhere too, technically no need to keep that onshore. May eventually get legislation that would guarantee that, but only after a wild west period that lasts a few years.
I worked for a mature healthcare company and much of our marketing centered around healthcare provider surveys of doctors and nurses. The results were unsettling. Extremely high rates of burnout, typically due to administrative overhead. Horrifying medical error rates. Doctors should be compensated for the amount of time to send an email. Every other industry is capable of restructuring support to satisfy demand. It'…
>The real question is: what would it take for the healthcare industry to restructure itself to actually function? Strike the words "over 65" from the medicare bill.
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Fighting the ER. The employee screwed up and did not go to the urgent care per policy for minor cuts. Still, it’s bad optics to fight an employee.
It’s bad optics to employ someone who doesn’t know what emergency means.