Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Tuesday, August 19, 2008

When Sauce for the Goose isn't Gravy for the Gander

So even though the insurance company (I won't say which one, but it's named after a color and a shape) requires that we submit claims within six months of the date of service (a "timely manner") they go ahead and recoup payments "in error" made in -- get this -- 2005!

Nothing we can do about it either. It's just deducted from a check that includes payments for multiple claims, leaving us high and dry, bending over and taking it up the rear yet again.

I really need to go to a cash-only practice.


At Tue Aug 19, 09:52:00 AM, Blogger Lynn Price said...

These are the times when I wish docs could band together and force the insurance companies to play ball. I remember my ob/gyn tried this in our area. All the docs were on board for a long time until, slowly, one by one, the docs caved in to the insurance weenies. So everyone gets screwed. We pay higher premiums and get less coverage. Docs get less pay all around. Who wins? The insurance companies.

Guess that's why boutique practices are catching on in my area. Cash only, baby.

At Tue Aug 19, 04:19:00 PM, Anonymous Anonymous said...

I have been following your blog for some time now. I think this is the second, perhaps the third, time that you have brought up the idea of going to a cash based practice. Now is the time to do it! You did not select your patients insurance-they did. I doubt that an insurance company would try to collect a three year old "error" from the insured! From you its easy, just deduct it and send you a notice!! No discussion, no appeal?? I wonder how often these errors are found and why punish you???

At Wed Aug 20, 12:14:00 AM, Blogger Toni Brayer, MD said...

This is one of my pet peeves...but as I think about it there are so many things to be annoyed about with the insurers. But what can you expect when they are retaining profits for investors? That is their business...not paying claims.

Most doctors don't look at the EOBs If they did they would be shocked at the number of ways they are being screwed. My favorite was when they bundled a physical exam (with pap smear and multiple co-morbid conditions) with a microscopic wet mount and paid me for the wet mount ($22.00) and nothing for the extended visit.

I could go on and on. Like tom suggested, I have dropped all insurance now (except Medicare because I feel sorry for my seniors) and my frustrations are gone. If you can do it...I recommend it highly.

At Wed Aug 20, 11:04:00 AM, Blogger Gary M. Levin said...

This should be reported to the insurance commissoners in each state. If they received thousands of complaints from docs, patients, they may very well rule on this ridiculous practice. If they can figure out something before six months to pay for then they can figure out in six months what you owe them. If they are stupid enough to overpay it's their problem not mine. If you bought tires and overpaid, do you get a refund in three years?

At Wed Aug 20, 05:21:00 PM, Anonymous Anonymous said...

This comment has been removed by a blog administrator.

At Wed Aug 20, 07:41:00 PM, Blogger #1 Dinosaur said...

Dear Anon 5:21:

Thanks for the sentiment, but I'm still anon myself (for the time being, at least.)


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