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View Diary: Greedy big-profit health insurers charge patients for talking too much -- yes, really... (115 comments)

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  •  single payer ok/ Man is the Creature who bill (2+ / 0-)
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    isabel, cai

    When I order a ct scan for a patient with private insurance, there's a guarenteed 20 minute phone call for my office staff.  For a medicare patient it just gets done.  Single payer would be great. (That's just my convenience. Don't get me started about my patient who just died after her husband's drug plan lapsed & she stopped seeing doctors 5 years out from her bone marrow transplant, or my patient who was having cough & fever during chemo for breast cancer but kept going to work because she'd blown through her sick time.  RIP.  We need laws guaranteeing coverage & medical leave.)

    But this was a post about billing.  I used to do a monolog for the fellows & residents, called 'Man is the creature who bills.'  Short version: Whales have language, seagulls use tools & ants have social organization.  Billing alone seperates us from the beasts.

    Years ago I had a patient I followed for copd.  She'd had many other respiratory problems, since resolved.  I usually checked off a level 3 visit for the treatment of one problem that was stable, but after one long visit I submitted a level 4.  I got a call from the patient rep asking what was the difference, and I explained that they asked many questions.  I took renewed her medicines for copd, adjusted the dosage of her hypertension meds, took a look at the fungus on her toenails & suggested a pair of treatments (& prescribed the one she preferred).  There was also a long discussion of how all these meds interacted with her treatment for myasthenia gravis.  I don't know how the patient rep relayed this to the patient & her family (a traslator was involved) but at the next visit the sat stock still & wouldn't say a word, as if a meter was running. (they relaxed on subsequent visits)

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