ATV Florida Forum

Here's a regular scenario in my life for those of you that feel cheated.  This is how my pay check generally works.

 i treated a patient 9/4 and 9/18 from an auto accident.  the total bill for both days was $290.  by law i have 35 days to file the bill.  so i filed the bill w/in the correct time.  however, i just got an explanation of benefits stating that because i didn't have a particular number in a box on the form that they were not going to pay the claim.  so i called them and asked if i refiled the bill corrected if they would pay it.  their answer was no they would not pay it since it was after the 'timely filiing' deadline.  so now i get to write off 290 bucks.  i'm so fu@king discusted w/ this chit that keeps happening where i have to work for free.

the rest of the time when i do get paid the ins companies make me wait 3 months for payment and they cut my bill by 2/3's including the copays.  even worse i have to call on most of them to get paid.  thank god i don't have staff i have to pay to do this job.  then i'd make no money after what they take from me.

two ins companies i dealt w/ today here's the results.  total bill for 2 patients on multiple days $560, total payment $85.11, total write off that i can not legally collect $474.11

now remember i owe 100K for my business loan not to mention my monthly overhead at the office.  then i also owe 200K for student loans.  sorry to vent and thanks for listening.  i love my job but i'm getting tired of not getting paid and there's nothing i can do about it!  don't tell your kids to go be dr's it's not worth it and it doesn't pay!

charge 2/3 more than what the bill actually is then you should get whats actually comin to ya j/k.insurance companies are nothin but a big scam if ya ask me.

doesn't matter what i change my rates to.  then i will get paid less percentage wise.  i calculated what their current pay is.  they currently pay 1/3 of my current rates.  if i raise my rates they will pay the same amount and i will write off more.  in addition i have to charge cash and insurance patients the same fees.  my current rates are standard for this area.  if i raise them the irs, insurance commision, as well as my state and national board will come down on me and i could lose my license.  wish it were that easy.  thanks though for the thought.

that s u k s!!!!! i dont give my customers a choice. pay me or suffer an untimely death. i learned that from mr. bones himself!!!!  ;) jk

WHY?   Doctors make good money

Doctors have a more powerful lobbyist with deeper pockets than chiro's do. ;)

I doubt I would have given in re the "timely manner" issue.  You filed the bill in a timely manner per your post.  Call again and demand a supervisor.  Your filing was made timely, an error is possible on either side.  I would be double D'd if I let them take my money out of my pocket.  I have dealt from the patient side with two insurance companies for the last few years.  I dog them until I win and refuse NO as an answer.  Go as high as you need on the ladder, someone will eventually give and you will eventually become known as hard nosed and not going to be pushed around.  It doesnt matter if they like you or not, they are working for the patient and you.  Not the other way around.

but don't you do  like any other DR.'s office I've ever been to?  What the insurance won't pay you just back charge to the patient and overall the patient takes it in the shorts because they have crappy insurance?

Not to minimalize your troubles, but that's been my experience.

My uncle is a family practice Dr. and his biggest complaint is the Organized crime group called the I.R.S.

When I got in my accident and had to go the hospital all I had done was a series of X-rays. They tried to charge me $1285 dollars a few months after. They were dumb enough to lose my insurance info and trying billing me instead.

Anyways after we clear that up I found out that they settled with the insurance co. for $235 dollars. What kind of crap is that, there we go again with big company's getting a break.

There's people that think that there's no problems with our health care system, mostly conservatives. You tards need to wake up. Quit listening to paid off idiots like Rush Limbaugh, Bill O'reilly, Shawn Hannity, Glenn Beck and all the other idiots. These A-holes left there dignity back at  in there mansions.   

Alright, let me get this straight. Your Tata's grow when the insurance company jerks you around? This I gotta see. :D

no.  tatas are not going to grow... sorry.  I didnt want to use a curse word, but I guess I could have said "danged".  buddy, you are keeping me on my toes these days!!!  :-*

I was gonna have Jen try calling the insurance company tomorrow and stir the pot a little if that was the case. :D

Looks like you have been handling all the insurance issues in your family with those moobs.  :D

Allright smart a$$. I was gonna make a smart comment on a thread you posted in earlier but I didn't. Looks like now I have to go find that thread don't I? ;)

haha.

arent patients ultimately responsible for what the ins does not pay? I know I have signed those forms in the past.If the insurance only pays xxx than the person who got the services is due to pay the rest,simple,or put them in collections. Business is business.Why should they get off for what the ins dont pay?

GL

As a dr that is contracted through the ins companies I can't legally balance bill the patients which is what you are talking about.  Most ppl won't go to a dr that is out of network for that reason.  I am on a couple networks to get my business going.  Once I have enough patients to loose half of them I will drop all insurance.  Because by dropping insurance I will lose half my business.  Basically I have to work 3x as hard to make the money I should make from full payment.  In addition, I give services that the insurance companies won't pay for for free.  I write those services off and never bill for them.  Why?  Because I have to do the best by my patient in my hypocratic oath.  And if my patients don't get well and I know they'd have gotten better w/ all the treatments needed then they will refer.  If I limit them to their insurance coverage I can't possibly get them well.  Then they will bad talk my business.  I take more than a 2/3's loss when you consider what I can't bill for to get my patients well. 

I have several patients in collections w/ a 10% compounding interest every month and yet they still don't pay.

I bet the two Lurkers viewing this topic owe you money. LOL   COWARDS!!

trx9 has it pegged on how things work in my business. thanks for understanding. 

renmus i have already climbed the ladder to get answers and they keep telling me no.  i'm just happy i didn't have to pay someone else to file my claims wrong.  then not only would i be out payment.  i'd be in the negative for their paycheck.

lmao i've already helped ppl on this site for free.  so they owe me nothing but when it comes time that they have something to trade out i'll be calling them.

Hhmmmmm that doesn't sound right.......  Just a few weeks ago you mention how good you're doing, what happen?

I think the problem is that you need an office manger to run your office. How long have you being in business? And still no permanent customer base? Something wrong! need to look and see what need to be done before it goes down hill, if it is not all ready.

Sorry QT, but you came on the internet to air out you're business problems, I guest looking for advise.

We spend $10 Billion a month in Iraq while tens of millions of Americans can't afford health care and we can't afford to pay teachers, public safety officers, etc. a decent wage?

oh don't get me wrong the business is going well for sure.  i have a permanent customer base that is growing each month.  however, it burns my azz that i have to take such a hit every time a check comes in.  like i said i have to work 3x as hard to make the money.

Not to make light of your problem but there was a time not too long ago where Insurance Companies Scoffed at Chiro's .......My mother hase been in the HealthCare field for 30+ years....and remembers it was not that long ago...so progress is still progress....My Dentist is a Bar Musician on the weekends....My Wife's Supervisor @ Costco ...leaves his day job to work at Publix at night...I have been at my Job for 12+ years...and I occasionally supplement my income with Bartending or Odd Jobs...Things are tough all over the economy is in the crapper....I am thankful I have gainful employment..I am not afraid to admit that.

I wished the insurance companies still scoffed us.  Because when they did the patients that saw us payed cash.  It was like the patients that go to massage therapist or acupuncture.  They all know that most insurance won't pay but they know the value in the service they are seeking for their problem and are willing to pay for it.  Since we are on insurance we are "seen" as dr's by some, but still not all and patients that do come in most of the time won't pay out of pocket and they won't go outside their insurance.  It was better for my industry before insurance got involved.

I understand what your saying about supplimenting income.  I'm never too afraid to do what I have to if need be.  My parents taught me to never be too proud to work that nothing is beneath anyone as long as your earning an honest wage.  I'm not saying I'm broke or the business is in trouble.  It was just frustrating as hell to look at how much the insurance companies make me write off that there's nothing I can do about.  I'd be in great shape if it weren't for them.

Thanks for the words of advice though.  Sometimes they are needed to keep us in check.

My daughter fell out of the stroller & nearly bit her tongue off when she was 2yrs old. I was sent to an oral surgeon by Humana HMO. He agreed to see her thru Humana. Well Humana didnt pay what he expected to get & he tried to balance bill me when I took her in for her 1 week follow up. They refused to see my daughter unless I paid them $800 & she has never been seen or released by that Dr. on that issue. She is fine now & dont remember being put in the pappoose & her tongue pulled out of her mouth & 46stitches inside & out of it. I sure as heel will never forget how i felt about it. I cried like a little b**ch hearing my little princess scream from the bottom of her soul. She still has fear of Dr's, but cant tell you why... I hate that Dr. & I hope we never cross paths.
She is ok now & talks normally now she is 5yrs old & the teachers pet in Kindergarten.

I keep telling my son to be a LAWYER!!! 
My little girl wants to be a teacher "like mommy".
works for me.
On the side note, all insurance companies suck big ones!!!

There are crooks in my business also that don't know that if you're in network that you can't balance bill a patient.  Or their insurance department doesn't fully explain a patients out of network benefits.  However, it is not our offices job to explain a patients benefits.  Ins is a contract between a patient and that company so it is the patients responsibility to understand their insurance.  However, most dr's offices will take the time to sit down and go the extra distance and explain how it works w/in their field.  There are truely some ppl that don't know that if you are in network that you can't balance bill.  If you were seeing a dr that was out of network and they agree to accept Humana they can still legally balance bill you.

That's where I am different is that if your daughter had come into my office I still would have treated her despite not getting paid because out of the goodness of my heart I knew she needed the care.  So the good dr's get screwed and the crooks get paid. 

I love it!   :ThumbsUp.gif

forgot to add i'm glad that your daughter is ok despite her dr.

oh sure raise your son to be honest and good then send him off to school to learn to lie, trick, and steal.  j/k sorry matt i had to go there.  it was just way to easy.

He loves a good debate at 9yrs old. He is also able to manipulate his friends & sisters words into what he wants them to be so I truly beleive he has what it takes to be one hell of a Lawyer. Oh yeah, he is never wrong either. ;)

You know what they say, "Lawyers are not opinionated....they're just never wrong." ;D

You know QT why don't you have one day a week, say Wednesday where you have a special. For cash customers only you could have a bone adjustment and a handy say for 50 bucks. Call it a crack/jack special.

$50? Hell I pay, errr, ummm, I mean I've heard that it's $80 in my area

Ouch......... ???

Did somone mention HAPPY endings ::)

ten dorra each

lmfao!  that's funny right thar!


nice. lol!