February 1, 2013

What Is This Charge From the Doctor?

Even though this information from Trisha Torrey is from Jan 7, 2012 and repeated on Jan 17, 2013, it is very applicable. Doctors are looking to stay afloat financially and are looking for ways to cover costs the government is making more onerous. Then add to this the requirements that the insurance companies are requiring from the doctors, this all adds up to costs the doctors are unable to continue to cover.

What is different today? Read this, “Up until a few years ago, if you needed a test or a procedure, then it was scheduled, you had it, the doctor billed for it, and the insurance company paid for it. With few exceptions, that's not the case today. Today, if you need a test or procedure, then someone from the doctor's office has to call and get permission for you to have it. With no permission, it doesn't get paid for - and not only will the doctor not get the money from the insurance company, but YOU will have to pay for it out of your pocket. That is why you sign all that paperwork that says you'll be responsible for anything that's not covered.”

I will let you read the article by Torrey and move on to the reason I am thinking this charge may get a lot larger. In my blog “ADA Changes Blood Glucose Monitoring”, I mentioned that the ADA wants insurance companies to be more flexible in reimbursing for test strips. Insurance companies are thinking about having meter downloads sent to them. Doctors will then be required to have software available to download the meters and most primary care physicians do not presently have the software. They will not accept the cost and the patients with diabetes will be the ones charged.

Chances are only the patients on intensive testing will be the ones charged, but it would pay to know what the doctor is thinking beforehand. If the costs the doctor will pass on are more than the cost of extra test strips, then it may not be wise to want them reimbursed. Of course none of this has happened yet, but insurance companies are considering their options to comply with the ADA especially if they get more specific next year.
One option may be for you to have the software on your computer so that you can download you own meter, and forward this to the insurance company. However, you will need to find out if this will be acceptable once your insurance company decides this is the requirement.

This is just one more example of how our insurers are being greedy at our expense and we end up paying double for their greed.

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