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WTF is really going on here?

Discussion in 'Rants, Musings and Ideas' started by FMyLife, Oct 9, 2014.

  1. FMyLife

    FMyLife Chat Buddy

    Well, I'll start out on a good note. I got a new psych. Those that knew about my previous will find that good news. But….

    So when I called to schedule new patient appointment, the first question asked to me was "What insurance do you have?" Now deep down I know int he United States that is a perfectly legitimate question. They need the information as well as to advise on the repercussions of using a doc outside of the insurance's network. But as an opening line? As if that was going to determine the next round of questions or determine the course they go with the first meeting. Now I am no stranger to the healthcare system. As much as I want to believe that it is non profit, its really not. Everything here as far as health is based on money. If you don't have it you are invariably fucked. So after I gave all the information they ad me go to their website for the new patient paperwork and all that and I got to exploring the site. If I miss this appointment, there is a fee of $300. That is the cost to cover that doctors one hour time block. Yes. This doctor receives 300 for an hour of your time. I couldn't believe it. If someone without insurance needed to seek mental health, its either go to the state hospital or pay out of pocket for one. $300 if you are seen without insurance. What is this paying for exactly? It's not paying for the meds. It might not even be paying for the help, dependent on if the doc is good. After that it 150 for each follow-up..

    I guess my point is that healthcare is just another profit bound corporation that cares little about what its meant for. If the healthcare can't make profit off you, then they don't help you. Yes, some places have free clinics to help the needy but the quality of care is no match for what someone with money can get. You really think those free clinics are going to provide for someone in need of transplant, or anything else. Hell even the UNOS system is based on money….who can fork out the most for a kidney…..

    And the more profit driven it gets the more the general population suffers. The many billing issues that come to me regarded out of network labs and insurance based demands all because one little code wasn't right. Or if the clinic is careless with meeting the demands of the insurance company. And of course in the interest of insurance, you are just a fucking number. Member number 847947502….. And if your stuff goes to the wrong lab you are fucked, and the hospital doesn't want to take the hit for it so you end up paying out of pocket because your clinic fucked up, because that 800 they might lose if you don't may make or break the bank.

    Eh what the fuck am I even ranting about…"who is your insurance carrier" just seemed to be a very impersonal greeting…as if i wouldn't be spoken to if i answered that question wrong...
  2. SoleSpider

    SoleSpider Member

    Even 150 is absurd. I understand these doctors don't see patients every hour of the day but a lot of them do which is why there's always a 50 minute limit per hour, to give a 10-minute buffer for them to write a few notes and jump into the next patient. I understand that they are providing a service and spent a lot of money on their education. But 150 to 300?

    I've worked my ass of my whole adult working life in the technical field and after 20 years am in a high position with very good salary but am nowhere near even 100 per hour when broken down that way.

    Therapists are way over-paid. If they were more reasonable at 60-80 per hour then way more people could afford therapy and this world might be a better place.
  3. Petal

    Petal SF dreamer Staff Member Safety & Support SF Supporter

    300 really is taking the piss. You should have asked her is it April 1st?

    Seriously...I wouldn't have been so polite, I would have told her where to go. 300 IS INSANE. Yes, I get they are doctors, they have a license, a responsibility but when you see them asking for 300 for a missed session...makes you wonder, do they even like/want their job or the $$$

    Totally get where you are coming from, ''opening line-what insurance do you have''. My reply would have been 'hahahaha bye I will go elsewhere and also you learn some ethics you are supposed to be professional not an insensitive fool''.
  4. Petal

    Petal SF dreamer Staff Member Safety & Support SF Supporter

    Oh and I must add-are you sure it wasn't one of the patients you were talking to there, haha j.k :)
  5. nararabbit

    nararabbit Active Member

    Wow. That is way out of line! I live in a very expensive area of California, and have had three psychiatrists in the past 12 months. The first is in a very high end area (think Rodeo Drive in Beverly Hills) and she charges $160 a session, $120 if you miss, and $240 for a 2 hour new patient, including 24/7 phone support. The second is from La Jolla, and charges me NOTHING, just what my insurance pays, and he has Saturday and Sunday hours! The last (my husband's psych) is $65 per session, $65 if you miss, and they're generally 15-20 minutes long every three months (he's stable and rarely changes his meds.)

    $300 is outrageous and I would go elsewhere. If nothing else, I feel that is unscrupulous and taking advantage of what is the most financially challenged healthcare group out there.
  6. JmpMster

    JmpMster Have a question? Message Me Staff Member Forum Owner ADMIN

    The "doctor" does not get $300 for an appointment. I have no idea what th e$300 for a missed appointment is about but $75-$150 is about right for a dr appt and a typical dr appt is 20 minutes actual face time with the dr. and most plan on at least 2 visits an hour. Overcrowded offices they can get as high as 4 visits per hour but that is because bigger staff to do all th eprep work and paperwork and dr just flies in and out so very little face time. Some specialist get a little more , cardiologist and neurologist for example. A psychiatrist is a specialist, they have a full medical degree plus a specialty in psychiatry.

    That $300 for an hour pays the Dr , the receptionist, the building, the insurance specialist, the nurse that takes the BP and medical history before you see the doctor and the, the medical transcriptionist that transcribes the doctors notes into the required format for entry into the computers for the insurance company, and the call service he uses,and now the extra tax on the doctors office to pay for the "affordable care act", all the medical equipment (which also had a new tax added onto it for the ACA), and the facilities, and malpractice insurance for all of them because here in the US we have 20x the number of lawsuits as the rest of the world so malpractice insurance is usually in the $50k/ year range.

    The doctors also all figure about a 30% non payment rate- another words 3 people out of 10 never pay at all, so they have to charge enough for the other 7 people to pay for all 10. That used to be reimbursed by the government but part of the ACA was to eliminate federal reimbursement for bad debt, so all doctors have increased their fees to make up for that. That was needed because it is how the government paid for another part of the ACA.

    Compare this to for example the mechanic that I had put new breaks on my car with the sign for hourly labor rate of $80 per hour or book hour or clock whichever is longer- another words if the book say sit is a 1 hour job even if it takes him 25 minutes to do it they charge for 1 hour but if it takes 1 1/2 hours to do they charge for 1 1/2 hours. While the garage also has a lot of overhead, it is not near as much as a Dr office and the comparison in training and education is not even close. The plumber I use charges $90 an hour , and that is just just him and his truck.

    My Daughters counselor- just a psychology/counseling degree and no staff really is $90 an hour. Both she (that is not on my insurance plan) and one of my Dr that do not take my insurance but i do not want to change them just because with the ACA my insurance turned to shit, give me a discount because I asked for it and told them I am paying cash. Most places will if you ask ahead of time and are paying ahead and not being billed.

    I am not saying that it is a bargain - and most no-show fees are like $50 so $300 no show is a bit over the top - around here but my point is $300 for an hour is not really out of line with many things is not more than a regular dr that sees 2-3 patients and hour, and is certainly not out of line when you compare it to most blue collar trades jobs that do not require 10-12 years of education and $250k in student loans in order to even be qualified.