So now my health insurance company is dictating what I can tell my doctor

[bbach]

Warning - rant happening - I went in for my general physical yesterday. Currently my back is in great pain. So, I began to visit with my physician about it. The whole thing turns into a lesson from him on filing health insurance claims. If he turns the "preventive" visit into a "problem" visit, or one problem into another, then it gets coded differently and the insurance companies will pay differently, possibly not paying for all the blood work and tests etc.

So now I have to restrict my doctor visits to one problem at a time. Thank you Blue Cross Blue Shield. I love multiple doctor visits.

End rant.

[Guitzilla]

I do billing and coding for a livingin Illinois. BC/BS may pay differently in your state.

 

Many insurance companies are getting to the point that they won't pay for an exam and other services on the smae day, however, if he were billing out an exam charge, there are many different "levels" of exam charges that are based on the intensity of the exam. He should have been able to examine your back and just use one of the upcharged exam codes. It sounds to me like his office may not have a handle on billling and coding. The way that we code has been set up by the feds (Medicare)...it works, but is a very confusing system to many.

[Kendrix]

Its clear that the well being of the patients is barely a factor as these cost-conscious policies proliferate. IMHO in the context of an ineffieicnt system such tradeoffs sometimes border on criminality. Common sense is nowhere to be found.

 

FYI- I spent a good portion of my retirement savings to get me daugher well after a sever head injury several years ago. We ended up the the grey area between a physical ailment and a psychological one ( that is not well coverd by insurance). I could go on for hours about the insanity that the current system imposes on us all.

 

IMHO, in may ways, the medical industry remains in the dark ages. An overly rigid and fractionated mess that is impervious to logic and common sense. The best plan is to never get sick.

[chevybusa]

 

Its clear that the well being of the patients is barely a factor as these cost-conscious policies proliferate. IMHO in the context of an ineffieicnt system such tradeoffs sometimes border on criminality. Common sense is nowhere to be found. FYI- I spent a good portion of my retirement savings to get me daugher well after a sever head injury several years ago. We ended up the the grey area between a physical ailment and a psychological one ( that is not well coverd by insurance). I could go on for hours about the insanity that the current system imposes on us all. IMHO, in may ways, the medical industry remains in the dark ages. An overly rigid and fractionated mess that is impervious to logic and common sense. The best plan is to never get sick.

 

 

+1,000,000,000,000,000,000,000,000,000,000

 

Kendrix absolutely nailed it. I've been in the trenches of healthcare for a few years now, and while I really don't want to offend anyone else who works in healthcare or anyone who has a positive view of it and/or has benefitted from it, what I have witnessed with my own eyes and experienced first hand over the past few years has...actually, words cannot even begin to express my disappointment, disapproval, and disgust with what the true reality of healthcare (in all it's many forms) is and encompasses. Words cannot even begin to express how unbelievable and unacceptable it is that such unfathomable harm is caused by such incompetance, negligence, apathy, malice, and blatant lies of self-indulgent pride that masquerade as something so noble, pure and benevolent.

[UstadKhanAli]

Back problems are horrible. Sorry to hear about that. My lower back always hurts, and I'm going to a chiropractor currently, which is definitely helping so far. I have no advice to give you other than if you can afford it, try and get a PPO.

[MrKnobs]

 

IMHO, in may ways, the medical industry remains in the dark ages. An overly rigid and fractionated mess that is impervious to logic and common sense. The best plan is to never get sick.

 

 

I think you mean the health insurance industry.

 

Medicine in the US is superb.

 

Terry D.

[nerol1st]

I used to have a PPO and man was that nice. They don't have it anymore (not in 3 years) so now I have {censored}ty HMO.

 

You basically have to ask to wipe your ass.

[bbach]

 

I do billing and coding for a livingin Illinois. BC/BS may pay differently in your state. Many insurance companies are getting to the point that they won't pay for an exam and other services on the smae day, however, if he were billing out an exam charge, there are many different "levels" of exam charges that are based on the intensity of the exam. He should have been able to examine your back and just use one of the upcharged exam codes. It sounds to me like his office may not have a handle on billling and coding. The way that we code has been set up by the feds (Medicare)...it works, but is a very confusing system to many.

 

 

My wife works in the lab in one of the hospitals here. She says they are having a harder and harder time getting things covered. Insurance companies seem to be trying to cut losses buy raising premiums and refusing to cover claims. It's a battle. Frankly, I never used to care, but now I'm not a spring chicken any more and health care in this country is a bit scary. I don't think there is a perfect system, but I'm still in favor of some sort of socialized system as my Canadian friends have, even with it's pitfalls. I realize that the huge money in health care in the US does draw the best medical people here, but the system is broken and needs to be fixed.