Reply to Advanced Primary Care Management- PCP Medicare

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][b]Why not just bill higher for an appointment? [/b]The fact that Medicare doesn't  pay much is not the patient's problem. Why are they billing for nothing that has transpired? How is this not concerning, and yes, sketchy? 
I have a specialist who gives out his phone # (hopefully it's not abused, but I'm sure it is,) calls to check in frequently, orders tests from  his living room if he has to. Medicare  pays a fraction of his bill and yet he isn't  finding hidden workarounds to get paid  more.And yet my primary care dr, who is managing none of this, is asking  for more  money  for managing this? He's not managing this.

What?

I guess they all can refuse Medicare, but I'm  not sure why the patient  will fill the gap here considering there's Medicare and Supplemental policy. If the supplemental policy refuses,  how is that the patient's problem?[/quote]

Because the cost of appointments isn't the issue. Mountainous administrative hassle (preauthorizations, script refills, fighting insurance companies, etc) and communication with patients outside of appointments (a million portal messages about side effects, do-I-need-to-be-seen-for-this, etc) is the issue, and this tends to be related to managing people with chronic issues. Could you bill more for appointments to offset that? Maybe in theory; but Medicare isn't going to allow for that. No one is "finding hidden workarounds" here; doctors are just trying to get paid for the labor that has gone unpaid for a very long time and had finally hit completely unsustainable.

That said, it sounds like you pcp doesn't have to manage anything for you. Fine. Just opt out of this fee or whatever. [/quote]

I don't think it would be unreasonable to charge a small fee for portal messages and RX refills and the like, but to charge a monthly fee when there has been no contact is not ethical IMO.[/quote]

I think  I was clear- this practice does  not  prescribe anything  for me. The only portal  message in the last year was a referral for a second  call back for radiology appt that they didn't send me to to begin with, it's just a yearly thing that I did need a referral for to do a second  look-  and it took a 10 days to get it with 3 different messages. 
If you think  all those things you listed  above are a problem  for a practice,  and they need more $$, then  why  is my secondary not paying, and all other patients not on Medicare  not being charged? Yes, it seems  really  suspect. I am "not in a rage." I am asking to see if this was ubiquitous,  and,according  to my friends,  it is not.

What  this means is that we all  will now be paying  for concierge services which, way more  that this surcharge, and, in my view, will only compound the overwhelming disconnect problem  in healthcare. I say charge more  to everyone for the appt  or whatever, and deal with insurance,  but  this makes  little  sense. [/quote]

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