Why do doctors offices charge so much for a brief visit?
- Thread starter BrianNole777
- Start date
True, but here's a funny story.
About two weeks ago, i had a standing zoom call with one of my clients with about 20 of their lawyers on the line, dealing with an extremely late-breaking development, on an incredibly niche-y drug pricing issue that a limited number of lawyers think much about. At the end of the call, they asked me the 'so what do you think will happen next?' question, which i answered.
the lead guy sort of smiled and said, 'so you know, just for fun, we asked chat gpt the same question and it gave the same answer you just did.'
Interestingly, as a short term matter, both of us ended up being wrong, but I suspect we'll both be right with the passage of a little more time. Or as a good lawyer might put it, "it depends on what the meaning of 'next' is"
this week one of mrs a's vaccine-obsessed friends (sorry brian, though nominally catholic she is married) was asking "which" vaccine she should get this fall. Mrs. A told her "whichever company you hold an investment interest in." That prompted a strange and displeased look, though i suppose at a certain level, for vaccines, it's theoretically a perfectly cromulent response.
I have no doubt ai will get better when the training datasets get better. Soon we will be working for out ai overlords.
yeah, our bd people have suggested we let ai take the first cut at our client alerts, to which i have responded, 'why, so i can sound like i'm stupid and write like a first year law student?"
My longtime primary care physician retired in May (he had been mine since 1988 and was awesome). I had a physical scheduled the week before he retired and he gave me 3 recommendations to switch to (the clinic had also sent a letter with a list of all the ones taking taking new patients). I do all of my scheduling and everything via text (it is so convenient and no waiting on hold - the clinic recommends it). My doctor had told me my decision really didn't matter as I go once a year for a physical and I'm very low maintenance. So I text that I wanted to switch to one of the 3 as my primary since mine was retiring and they responded that requires an appointment to make sure both parties believe it will work out. It was almost like an interview. He had gone through my records, noted I had just had a physical a couple weeks prior, made some small talk and he concurred that he would probably never really get to know me as I am not there much which is great. He agreed to be my primary, all good. Then I get a bill from the office for $300 less the insurance adjustment of $120 and I noticed it said "MOD VISIT" or something like that. So I called and said there must be a mistake as I had simply gone to get the ok to add him as a primary, I had no health issues or exam and the code said MOD. She said that wasn't a mistake, that is the lowest level visit possible. So I paid $180 to switch primaries and really had no choice since mine retired. Had a I known that I would have at least requested a prostate exam, a little something for the expense.
Dude, that's fraud. Plain and simple. It ain't an office visit if you aren't yet a patient and there was no examination and only review/discussion of charts.
Here are the new patient billing codes and related descriptors - note the need for an examination and for 'some' medical decisionmaking.
99202
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 20 minutes are spent face-to-face with the patient and/or family.
Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 15-29 minutes of total time is spent on the date of the encounter).
99203
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using time for code selection, 30-44 minutes of total time is spent on the date of the encounter.
99204
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using time for code selection, 45-59 minutes of total time is spent on the date of the encounter.
99205
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 60-74 minutes of total time is spent on the date of the encounter.
It's like the "sticker price" on new cars.
Specialist office visit invoices typically are $400-500; negotiated rates insurers pay will be $150-200.
If you pay attention to what you are paying in premiums per month, for that "$40 copay", it's probably costing you a lot more than a higher deductible plan where you'd just pay the $150 negotiated rate out of pocket.
Those Silver and Gold insurer plans can run $100-200/month (or more) than the higher deductible ones.
If you make 6x office visits per year at a $40 copay, that's $240 you're paying, along with and extra $1000-2000 per year for the higher premiums (some more like $3000-4000/yr more).
Paying the full visit costs at $250 each would be $1500; only $900 if those negotiate visit costs are $150 each.
It benefits you to review your healthcare usage AND what those negotiated insurer rates are, because those higher tier plans often cost you a lot more than you realize. People with expensive pre-existing conditions (diabetes, etc) who will need regular visits and have major monthly costs are much better off on the higher tier plans. People who have infrequent visits rarely benefit from them, and pay way more in premiums than they would on higher deductible plans.
Make a spreadsheet; track them. Put in what insurance paid vs the invoiced amounts, because those negotiated rates are what you'll pay on a higher deductible plan.
You're paying for wasting their time begging for another jab. It's a PITA surcharge.
The problem w/ AI-generated answers & output, is that any AI system that is fed AI-generated data becomes unstable over time.
And the people programming these systems are becoming more and more unaware of whether the data they are feeding them is human data, or AI generated.
Once these systems start generating their answers based on other AI-pushed answers, things will go sideways on them; unless they actively manage them and ensure they are not re-using AI answers to train them.
“Jammed balls”….I once overloaded a ball washer at the local golf course. Does that count?
I'm sure it's huge.
Either way, doctors in America make double or triple what doctors in other countries like Canada, Germany and the U.K. do.
I'll just say the ui nursing program is in extremely good shape.You really are a rotten sumbitch, aren’t you?
Wilbert Harrison said the same thing about Kansas City….wasn’t it 12th Street and Vine?
In general, it seems like the cost left over after insurance is what things should actually cost.
