Originally Posted by HomeService
they get paid so fast by the government. I guess they would rather take a discount- and get paid quickly.
that's nice to know...
[COLOR=Blue]However, though, that's not all together true. Your doctor friends are: either in the minority, or are just pulling your leg. Doctors, just like all other folks, don't have the time to do the due diligence of Medicare Advantage and Medicare Supplement Plans.
In actuality, the physician is reimbursed within 30 to 45 days from a Medicare Advantage Plan, because they are dealing directly with the insurance company, who pays first, then they, the insurance company, files with Medicare, and waits for reimbursement. Which, in and of itself is not the truth, because CMS prepays the insurance company an outrageous amount per month, to take care of the Medicare Beneficiary.
If the physician bills Medicare directly, the waiting period for reimbursement expands to 90 to 120 days. Which cuts drastically into the appeals process that each Medicare Beneficiary has a right to. (this means it can take up to 90 to 120, not that it will - for those of you who were about to call me on the carpet for that statement)
Doctor's are not working with Medicare Advantage plans, primarily, because most of the companies that represent these plans (Universal, Pyramid, Arcadian, etc.) are not known to these physicians, and they are not going to use their resources (staff), nor their time to forge a relationship. They had too much to do, as it is, treating their patients, keeping up to date on the latest drug, leasing equipment, hiring/firing staff, etc.
The Medicare Advantage Plans that will survive, after the shakedown, will be the companies who also offer Major Medical coverage (Blue Cross, Humana, Coventry, UHC, etc.) for no other reason than the physician has already worked with their billing department, and the transition is seamless.
Let me drive the point home: How many of us "insurance agents" take the discount card programs (IAB, Family Care, etc.) seriously? A very small number, I guarantee you. Also, if you were to do a search on any of these plans, you will find that most of us talk about how much harm they do vs. what value they offer those that need/can use them, due to an uninsurable diagnoses (Cancer, Diabetes, Heart Attack, etc.).
Doctors are no different.
In the IFP market, I've come across those that tell me that their doctors tell them NOT to get insurance, because they will cut them a deal, if they pay direct.
Anyone believe that?
[COLOR=Red]"Listen, we're about to do an EKG. Rather than charge you UCR, I'll let you have it for $45, if you pay me cash, now."
[/COLOR][COLOR=Red][COLOR=Blue]Yeah, right.
I recently asked John Oxendine, Georgia's Insurance Commissioner, and Gubernatorial Candidate, about this very same topic.
[COLOR=Purple]His retort: The problem with the Medicare Advantage Plans, is that you have "two cooks" in the kitchen. The DOI regulates the insurance aspect of it. CMS regulates the dispensation of it. There needs to be only one who regulates it, and right now, neither party wants it.
[/COLOR][COLOR=Purple][COLOR=Blue]Getting back to the "accepting assignment" question: The doctors who want the Medicare Beneficiary to be more involved in their treatment options, and not run to the doctor for every little thing, don't accept it, so that the MB will have to pay for abusing the system. Those that do, feel they are there to service a segment of society that is "entitled" to this service, and has paid into it fairly and justly.
[COLOR=DimGray]Hopping back on my throne.[/COLOR]
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Do Most TX Doctors accept assignment?
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