Skip to comments.From a Doctor Who Will Not Comply
Posted on 03/24/2010 5:42:07 PM PDT by Sir Gawain
March 23, 2010
My Dear Patient,
As you must know, Congress has just passed extensive legislation governing health care delivery and insurance systems. Whether you agree with what it does or not, we are all now subject to this law and its sweeping changes.
I have always conducted my medical practice with my patients best interests as my first priority. Although not legally obliged to do so, I have routinely provided you with a receipt that has all the codes necessary to bill your own health insurance company for any reimbursement to which you are entitled. Until now, that insurance company was a free enterprise despite the fact that it was heavily regulated by state and federal laws. Now the situation is quite different. Through the new laws mandates, regulatory powers and reform, health insurance is and will be largely a government activity which will have an ever larger jurisdiction over how doctors practice, make clinical judgments and are paid.
(Excerpt) Read more at corner.nationalreview.com ...
Hey, I like this doctor. Is she a GP or a specialist or what?
(And, by the way: What the hell is wrong with FR tonight? It’s either locking up or getting kicked out.)
Where does she practice. I’m not opposed to driving across the country for my medical care. God bless this doctor for putting her PATIENT’S ahead of this crapola
Amen. God bless our doctors. They already hate the constraints placed upon them by our insurance companies. But the Federal Government will be an impossible taskmaster.
I know many older docs who are “set” will be retiring early. I know many younger docs have decided to go back to school to pursue a different career.
Although your absence will be a great inconvenience to the rest of us, this new law targets you even more directly than we patients. So we understand and support your “going Galt.”
Hope to see you again after we have slayed the ObamaCare monster (and passed a constitutional amendment to guarantee that such a tyranny will never happen again).
By the way, isn’t it odd that the lawyers in Congress don’t see a need for the American people to have access to quality, affordable legal services? After all, if you can barely afford your health care premiums, how can you possibly afford to pay $200/hour for a lawyer to sue the a$$ off your doctor for malpractice?
You go, Dr. Johnston! I wish I knew where she was practicing; I’d go to her in a heartbeat.
The goverment has been getting between doctors and patients for years. Making mds ask about guns in homes, sex education.
Did you read the entire post? She's refusing to give her patients coded receipts (receipts with medical billing codes). Without these coded receipts, they won't get reimbursed by their insurance companies.
This doesn't put her patients ahead of this crapola. She's putting her political (and presumably economic) beliefs ahead of her patients. That's her right, of course.
Just to be clear: The doctor is refusing to give her patients receipts with medical billing codes. Without the medical billing codes, the patients cannot be reimbused by their insurance company.
It's her right to protest. This is not going to hurt the government, just her patients.
I appreciate the sentiment but this bunch doesn't obey the Constitution now so why would they obey an amended one?
After all, they are the ones who want to take our Constitutionally mandated right to bear arms away from us. How much plainer can that be? It is only the 2nd Amendment so what would another amendment do?
I have no problem with the doctor exercising her right to run her practice as she sees fit.
I’m not sure I understand what she’s doing differently.
Thanks for posting this...
Except for the fact that her patients’ medical records will remain private.
No, she’s just doing what my husband’s doctor did in advance of this Obamanation. She’s taking her practice private. She gives you medical care and you pay her, just like in the old days. Lots of doctors have already informed their patients of their new way to practice.
Of course. Not many doctors pay thousands upon thousands of dollars to go to medical school, spend thousands more for board exams and insurance, endure through thousands of hours studying and working in a residency and a fellowship just to satisfy a need to serve their patients for free.
Yes, I read it and she is putting her patients first.
If you want a coded receipt, there are all kinds of doctors that will be participating. Since she has decided to NOT accept any insurance, she is not giving the receipts. She is in the minority. Those, like me, who value their privacy will have a difficult time finding a doctor such as her. Those who have no problem with the government having free access to their medical records so government panels can ration out whatever healthcare they think you deserve will be able to go most doctors and get the coded receipts.
I think people will get the idea real soon that even health insurance may be a sham. We have a medical savings account with a $10,000 deductible. Our family (2adults and 4 children (9-19 yo) are covered for ONLY for catastrophic illnesses. When my husband did this at least 10 years ago I thought he was nuts but we have saved SO much money. We pay everything our of pocket including pharmaceuticals.
It looks as if she is prepared to try the concierge MD-VIP route.
Have posted on previous threads about this. For an annual fee (which is probably equivalent to an annual insurance premium) participating physicians give you 24/7 coverage.
But they haven't. Yes, they want to, but they can't. Because the American people have 250 million guns, and 2 billion rounds of ammunition.
*THAT* is what has protected our beloved 2nd Amendment, and that is what is going to protect all our other God-given rights, regardless of what the SCOTUS decides about ObamaCare.
In fact a friend from the UK just told my husband to relax about this new Obamacare. He said it just means that the people who can afford it will get the best doctors and those who are counting on the government for their healthcare will get the leftovers. It’s too bad the bleeding heart liberals don’t think their actions through all the way to a logical conclusion. This will just drive the best doctors into a private practice that middle income and the poor will not be able to afford. I’m not so cynical that I think it’s right to give the rich the best doctors and leave the rest for the poor. Obamacare will do just that.
“And if she sends you out for an MRI or Radiology or something, how will that work?”
Those are separate billing entities. The hospital or facility that the procedure was performed in will have their fees and quite often the specialist performing (or reading) the test will have a separate charge.
“Im not sure I understand what shes doing differently.”
She’s going to a “cash” based business. She won’t be providing the courtesy billing to insurances that many physicians do or the billing codes for you to submit on your own to the insurance company
Doctors would be more helpful altering their practice to either stop taking insured patents or reporting to patents to get back to their employer how much money they are spending on actual health-care, and thus how much money they could save by getting off the Government’s health insurance and going to direct pay.
Leaving the practice is not yet necessary.
You would be more helpful helping to change the practice to bypass the government.
This hints at the way forward.
Carry it to the next step to retainer medicine or concerge medicine (samething).
Sign a contract with your doctor direct. Negotiate monthly payments $250 for yourself to $1000 for a family of four. Ask the doctor to act as an agent for specialists by paying specialist retainers by adding an additional $100 to $150 per month. Or add a catastrophic policy at $75 to $150 per month (but this involves insurance which can entangle you with socialist government).
So for $350 to $400 per month for yourself you are completely covered by a doctor 24/7, a retainer or concierge doctor who will see you at any time or refer you to a specialist with virtually no waiting time.
If the monthly payment seems too much, ask your employer to pay you income instead of benefits. Put the extra income into a Health Savings Account and deduct from income at tax time. This is how it works now taxwise but that will likely change unless lawsuits or repeal are successful.
Remember it’s called retainer fee medicine or concierge medicine and its exists now. It’s not widely known (*see below) and it is NOT only for he rich. You can find a retainer doc for $2500 a year for yourself. That’s around the clock service and no waiting times, no seeing the doc for 5 minutes and pushed out the door; quality time, quality service.
*Retainer medicine is kept low profile because it is very competitive and much greater quality. Insurance companies do not want to see it become bigger because the insurance companies are heavily regulated by states and they feel it is unfair that retainer docs can avoid all that regulation. State insurance commissioners have gone after retainer docs accusing them of acting as insurance carriers rather than as contractors. The retainer docs have as a result kept a low profile. It’s a well-kept secret. The detractors of retainer medicine use scare tactics by saying “it’s expensive!”. It can be expensive, but so can anything else in the world of contracting. If you shop around you can find one at a reasonable price.
She will probably charge for an office visit... $50 or 60. She will also only use tests when absolutely necessary. Then we we see how much doctors practice defensive medicine. I had a doctor that made you sign a waiver understanding that she carried no medical malpractice insurance.
But won’t they require a “code” or something from the primary physician? Even if not, the patient would probably still have to have insurance to get the procedure done, unless they want to just get a big bill.
She’s precisely the doctor whom I would see if I could afford a doctor at all.
I can’t, & would probably be among the first adults to qualify for the gov’t run monstrosity, but I intend to avoid the government’s involvement in my health care for as long as possible. If i miss out on necessary medication that I’m running out of, oh well.
Notice that she intends to stay in business for the patients who stick with her, and of course she remains vulnerable to malpractice lawsuits.
When you run out of your prescriptions and need a refill find a walk in clinic and visit the doctor there. For $40.00 you can have script refill and ask him renewals as many as possible.
And she’ll save a boat load of money (if not already) by not having to employee 3-4 people (depending on the size of her practice) billing and rebilling and rebilling and rebilling the insurance companies (medicare is the absolute worst)and then sending her patients a bill and hoping that that the payment is received in posted in time to pay her employees.
As some of the pp have said, it won’t be those with money who can’t access healthcare. It will becoming increasingly difficult for those dependent on the government to access same the level of care. Currently, hospitals and physicians are able to offset some of their costs of the indigient and government dependents because patients who pay their bills and insurance providers. I suspect that before too long, in-patient care facilities will be following suit of the cash based physicians.
Tell your friend this is not so much about quality of care, that’s not the issue. Money will always find quality.
Tell them this is not about healthcare, this is about control, changing the nature and character of the relationship of the People to its government.
America was really set up different for the purpose of keeping the government at bay because history shows that persons in government ALWAYS seek more and more control, more and more taxes, more and more roles to butt in. It never stops, it is like greed to a banker; it’s hardwired into the human character.
The UK and its commonwealth are not known for medical excellence. America is known for medical excellence. There is a reason for this. It has to do with the fundamental notion of a market. In the UK, the market is the government. In the USA, the market is free persons or free entities driven to find new products and services to market.
In the UK you can find medical excellence in a black market or in a special secretive word-of-mouth clinic. But I can guarantee you that 9 times out of 10, the techniques and technology used in those higher end clinics were developed in American markets.
I’m not sure where you live, but many of the larger not-for profit Catholic facilities and associated physician practices provide services through what is considered “scholarship” or “assistance” that has nothing to do with the government (at this point in time:)). The programs are funded through large donors through the hospitals’ foundations.
Doesn’t gov’t control who can prescribe? And then, goodbye natural home remedies. All I take is aspirin - so I’ll just chew on some willow bark.
No...the billing codes and (diagnosis codes) are different. When the facility and the other physicians bill the insurances, they (or their staff) make their own diagnosis and for that diagnosis there is a correlating billing code that is sent to the insurance companies or the government. Nothing, in terms of money or payment, goes back to the primary (or referring) physician. The tricky part for these patients may be if their insurance company requires a referral from their primary care doctor to see a specialist. Most of my experience shows that as long as the primary care physician writes a “prescription”, that the referral is acknowledged and accepted. Maybe someone here with more experience could add something more:)
There was a discussion on a thread a while back and it was mentioned how health care costs started escalating when government introduced medicare/medicaid. Prior to that there was no need for health insurance because doctors were paid by their patients at time of service. Doctors also have been known to bartered services with patients.
Looks like KittyKat7 has been playing with too much catnip. If the doctor is not required to provide treatment codes, then they don’t have to provide them since they won’t be getting anything from the insurance companies.
OBAMA owns the insurance companies, GM, the Banks, and other little things in life. You are so screwed you don’t even know it.
My greater concern is this: If I can find a physician who opts out of the system,, as this woman does, I will. But I want to keep the government's prying eyes off of my medical records. I suppose I can get that reassurance from such a doctor, especially if I do not carry insurance (I plan not to comply), but that won't be the case for an MRI, Radiology, etc., where records will be kept and sent to the government.
I believe it. Any time the government gets involved the costs to providers goes up. A lot of our healthcare has been socialized (meaning government involvement) for a long time...from health department inspections to JCAHO accreditations to billing and coding regulations to licensure requirements to medicaid to medicare and the list goes on. The amount of staff required by an average sized hospital just to ensure compliance to all of the government regulations would probably surprise a lot of people.
Next time (hopefully not soon) you have to go to a hospital, ask someone if they have someone specifically designated just for compliance to HIPAA.
This is a conservative forum. This physician has every right to practice her profession in the manner she see fit.
“MRI, Radiology, etc., where records will be kept and sent to the government.”
What I’ve read so far of the bill, you are correct.
Currently, you enter into a hospital and designate how you are going to pay (insurance information or self-pay, etc.), that information will go into their electronic system. The hospitals I’ve worked in do not have the option to exclude you or your information from their system because they are in receipt of government funds in the form of CMS patients and thus because the government already essentially controls the functioning of the hospitals that accept their patients, they also control many if not all of the regulations within a hospital. The hospitals can refuse to comply (won’t happen) with CMS regulations but they will be “decertified” and will not be paid for CMS patients. CMS patients account for a significant amount of revenue for many hospitals.
Hospitals do have programs in which your name can be changed so nosy prying eyes can’t identify you (in the cases of extreme wealth, notoriety, fame, high profile case etc. or a victim of a crime or suspected victim), but the real id is always known on the backside.
“This physician has every right to practice her profession in the manner she see fit.”
For however long she is allowed to practice it. Failure to adhere to the rules will eventually result in having ones medical license pulled and with it her ability to prescribe drugs.
After listening to the discussion about the process which will be used to amend the Law to include children with pre-existing before 2014, it became apparent that Ms. Sillybus has broad authority to write specific regulations - which I am sure she will change on a regular basis. Given that, I would suspect that there may be a move to deny physicians the ability to practice medicine independently, i.e., on a private pay basis. BO is really pushing the electronic medical records issue but he doesn’t have a clue how much data will be descending on those trying to manage the program. Their systems are not state of the art nor are there enough people who can manage such systems. I would suspect that all of this is several years down the road and if we can’t get Congress re-staffed before them we are in real trouble. On the other hand, I’m not sure that the Republicans we have in Congress right now have sufficient knowledge to problem solve these matters either.
Well, then let's get to it! The "moocher" class is hungry. They're getting Obama money and free health care. And they want more!
Let someone suggest free legal services, and watch the corrupt lawyers who game the system squirm. How much you want to bet that they'd argue that a public option, access to quality, affordable legal services, would be "unconstitutional?"
I understand that. I've gone to doctors who don't participate in any insurance programs. I paid by cash, check, or credit card. The doctor's office always gave me a receipt with the correct medical billing code on it so I could submit it to my insurance company for reimbursement or to credit towards my deductible. But without a medical billing code, which this doctor says she will no longer provide, most insurance companies won't accept the receipt.
Again, the doctor can run a cash-only practice. That certainly simplifies things for her. But not providing a receipt with the medical billing code on it only hurts her patients.
Or am I missing something here?
How does providing patients who pay cash for her services with medical billing coded receipts required for insurance reimbursement EQUAL providing free medical care?
You lost me on that one.
She sure does! I hope NRO interviews her 1 or 2 years from now and see how her practice is doing since she started refusing to issue the coded receipts her patients need for insurance reimbursement.
She won’t have patients with any kind of medical insurance. I don’t know who that leaves except illegal aliens and crackheads!