Medicare PartB Payment to Dr Revealed

[policy doctor]

Now this is getting interesting. Just read an article that gov't will start to release the amounts they pay to providers for Medicare Part B.

Wonder why?? Is it to pressure drs to uniformly set their rates regionally, state-wide or nationally? I'm sure there's a long range goal here.

Or does POTUS think public will protest paying higher co-pays or co-insurance to their medical providers and demand lower fees?

This can't just be a more transparent government.

Medicare Plan B payment information for doctors will be made public | The Raw Story

 

[Josh]

Now this is getting interesting. Just read an article that gov't will start to release the amounts they pay to providers for Medicare Part B.

Wonder why?? Is it to pressure drs to uniformly set their rates regionally, state-wide or nationally? I'm sure there's a long range goal here.

I'm all for anything to move that agenda.

 

[policy doctor]

OK Josh....
Are you referring to uniform national rates or regional?

I guess rates were initially set based on local costs to a medical practice and whatever the area would pay. City vs rural, high population area like NYC vs Dubuque ,Iowa.

I think national rates might be devastating to individual/corporate practices but cheaper for the individual market. Again I don't know. All conjecture here.

 

[Josh]

OK Josh....
Are you referring to uniform national rates or regional?

I guess rates were initially set based on local costs to a medical practice and whatever the area would pay. City vs rural, high population area like NYC vs Dubuque ,Iowa.

I think national rates might be devastating to individual/corporate practices but cheaper for the individual market. Again I don't know. All conjecture here.

National rates would be absurd. I would settle for anything that promotes consumers looking at rates. I think there should be a sign on the wall listing rates for at least the most common/basic services. Consumers have no idea what providers are charging. If we're going to legislate the healthcare system and try to fix it with congress, that would do way more top address the root of the problem with our "system", the costs associated with it. Insurance is how healthcare is financed, not delivered.

 

[somarco]

Define basic services.

Preventive care is all free now, so no need to post prices there. Even birth control is free. That get's the drug stores off the hook.

Doc. How much is a basic colonoscopy? One where you just look but don't do anything?

OK, how much if we take off the anesthetic?

That much, huh?

 

[policy doctor]

OK...I agree with rates posted in a brochure(concept of rates on a wall remind me of a butcher shop) or quoted/est in person,phone, online.Those reflect the provider rates.

However, Medicare is insurance, like Obamacare(ACA) and I don't understand why the need to show what the dr receives from them...usually their EMOB shows that already. The disparity lies with medicare advantage plans and what they pay dr(hmo, pos, ppo) vs medicare and Plan F or Plan C.

 

[Josh]

Define basic services.

Preventive care is all free now, so no need to post prices there. Even birth control is free. That get's the drug stores off the hook.

Doc. How much is a basic colonoscopy? One where you just look but don't do anything?

OK, how much if we take off the anesthetic?

That much, huh?

I'm not talking about patient payment responsibility, I'm talking about a sign on the wall that lists what a basic office visit costs.

They get this with their eob, but that's after services are rendered.

 

[unic.consulting]

The basic office visit costs whatever the specific insurance company says it is. If a doctor charges $150 for a routine visit here, then depending on the insurance company this may be knocked down to $86. So the doctor's office bills for $200 instead? They still get $86. It's all based on the code the doctor uses for the exam. There is no easy calculation and each insurance plan has a different schedule. The EOB is really the only way to know what the charge is going to be.

 

[somarco]

I believe this is what Medicare pays, Part B. Has no bearing on MA payments.

 

[Josh]

The basic office visit costs whatever the specific insurance company says it is. If a doctor charges $150 for a routine visit here, then depending on the insurance company this may be knocked down to $86. So the doctor's office bills for $200 instead? They still get $86. It's all based on the code the doctor uses for the exam. There is no easy calculation and each insurance plan has a different schedule. The EOB is really the only way to know what the charge is going to be.

All that notwithstanding, doctors do have fee schedules and if those were posted I believe consumers would make more informed decisions.