Medicare Allowable Causes Increased Costs

I know this thread has turned to Medicare fraud but the point I was making was that it is Medicare, a government monopoly, that caused docs to find ways to make up the shortfall.

My mother's doctor received $21 for an office visit through Medicare. That's not enough to keep the lights on. So instead of charging non-medicare patients $50-75 he must negotiate with carriers for much more. This causes all premiums (except of course Medicare) to skyrocket.

It's no wonder we're running out of doctors. Why spend $500K in medical school when they could get a job flipping burgers for $10/hr.?

Adding millions of people to Medicaid has a similar effect. What amazes me is that some agents look at Obamacrap as a good thing because they're making bank. I do pretty well with MA and Supplements and still would end Medicare in a heartbeat.

Rick
 
I have the EOB and still can't believe it's $21.30 for "type of service - Office Visit." The doctor billed $100 and the allowable was indeed only $21.30.

Rick

Is there a CPT code associated with the line? I honestly can't imagine them allowing anything less than $75 unless it was a visit for an injection or something.
 
Is there a CPT code associated with the line? I honestly can't imagine them allowing anything less than $75 unless it was a visit for an injection or something.

The EOB is actually from the Plan N sup carrier where the office visit of $21.30 was listed as applied to deductible.

An injection would have another code. It was indeed an office visit.

You don't have to "honestly can't imagine" if you'd like. I was amazed and emailed the doctor to congratulate him on his new minimum wage job.

Send me an email (below) and I'll be happy to prove to you that I can indeed read.

Rick
 
The EOB is actually from the Plan N sup carrier where the office visit of $21.30 was listed as applied to deductible.

An injection would have another code. It was indeed an office visit.

You don't have to "honestly can't imagine" if you'd like. I was amazed and emailed the doctor to congratulate him on his new minimum wage job.

Send me an email (below) and I'll be happy to prove to you that I can indeed read.

Rick

Sent the e-mail. This is crazy.
 
Let us know if you can actually prove that Rick read it. I would bet that his mother read it for him...

There was a bunch of underlines and phonetic markings, so it looks like he sounded it out pretty well.

Honestly though, I've read a lot of EOB's, and this is one of the least informative ones I've seen. If she was my client, I'd probably suggest that she check the status of the original Medicare Claim and see if we could find some more information.

----------

Found out more information...It was a 99211 visit.
 
There was a bunch of underlines and phonetic markings, so it looks like he sounded it out pretty well.

Honestly though, I've read a lot of EOB's, and this is one of the least informative ones I've seen. If she was my client, I'd probably suggest that she check the status of the original Medicare Claim and see if we could find some more information.

----------

Found out more information...It was a 99211 visit.

How much would a similar code pay under a private plan, such as a group?

The answer is "a hell of a lot more." Docs can negotiate with private plans to make sure they make up the loss from Medicare.

I'm amazed some people don't see this.

Rick
 
Back
Top