Feeling Like I'm Being Used As An Excuse To Bill My Insurances

Discussion in 'Health & Wellness' started by John Brunner, Jun 14, 2021.

  1. John Brunner

    John Brunner Senior Staff
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    I've commented before that I had a urologist who would go into their online system and make appointments on my behalf without and discussion or notification, and I swear it's to fill blots in her billable schedule. For that and other reasons, I switched urologists, and had my first appointment with the new guy a month ago. He set a return appointment for two months out. His practice was in the process of automating, and I think their new system has a feature they've decided to implement.

    I got a call today from his office.

    Urologist assistant: "This a Tracy with Dr. xxx's office. We have a new program where one of Dr. xxx's assistants will call you once a month and ask questions to help Dr. xxxx stay on top of your health. I see you have Medicare and Blah Blah supplemental insurance...this would be no out-of-pocket cost to you."

    Me: "Well, I don't really see the need for this. I don't have any chronic health issues that require such routine monitoring. And without putting too fine of a point on it, I don't want to participate in a program whose primary benefit seems to be sending a bill to my insurance providers."

    Urologist assistant: "Okay." We can disenroll you from the program. Bye."

    This is crazy. Is this the norm for people when they go on Medicare? I've been on since mid-2019 and really feel as though some offices see me as a conduit to government dollars. It makes little sense, since I've been insured most of my adult life and would think if this were a motive, it would apply to anyone who's got insurance regardless of their age or of who the carrier is.

    Maybe my age has opened me up to this.
    Maybe COVID has made practices try to make up the lost cash.
    Maybe I'm over-reacting and should sign up to have a monthly conversation with my urologist's assistants.

    I hope I didn't unfairly slander them.
     
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  2. Jeff Elohim

    Jeff Elohim Very Well-Known Member
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    They are in business to make money, more money, then more money.

    Insurance , as well as doctors, nurses, hospitals, clinics, and mostly pharmakeia,

    has been doing this (they planned for it for over a century now, by their own admission in 1902 and following)

    for decades, btw. (un-necessary procedures and surgery, visits, xrays, and so on)
     
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  3. John Brunner

    John Brunner Senior Staff
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    Yeh, the last urologist wanted me to come in once a quarter to get my 3 remaining kidney stones x-rayed, even though they are not problematic and even though I've had stones for over 30 years without incident. I laughed and told her my first incident I passed over 10 stones the very first day, and to not bother me with monitoring 3 of them every friggin' quarter with no definitive action plan should they start to move.

    The new guy wants me to come in every 6 months for x-rays. I'll push back on him at some point. I'll get a baseline x-ray just to take a look and then we can talk about the future need. I didn't want to be argumentative right off the bat about some future event. He can get to know me before we have our first spat. ;)

    Regarding your statement that everyone is in it for the bucks: there is a natural conflict between insurance companies and providers. Dollars flow in one direction only. So insurance companies certainly are not colluding with these unnecessary procedures...they will be funding them. Maybe insurance companies influence what doctors do by deciding where the money is. Maybe.
     
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  4. Hedi Mitchell

    Hedi Mitchell Supreme Member
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    Insurance companies have and still run everything in the medical field. Plus when doctors join or become members of a particular medical institution, that company and the insurance companies work together telling the doctors what to do and not do. My primary doctor told me several years back, about how doctors must endure the heat from both. He said - I use to welcome people to joining the medical field, now I Quote " tell them to run like Hell in the other direction." unquote .And, not just my doctor who felt like this. There are those doctors who refuse to abide by the insurance rules , and once their found out -bingo they move on or retire- early. Found that out the hard way.
     
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  5. Yvonne Smith

    Yvonne Smith Senior Staff
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    I had the same thing happen to me. I changed doctors, but found out that it didn’t much matter, they all do the same thing. But the new doctor is at least checking for a valid medical reason. The first doctor would only renew my prescriptions for 3 months and then he had to see me, even for no reason, for me to get my meds refilled again.
    When I left that doctor, I also got in touch with my cardiologist, and moved my heart meds back to their office, and they happily give me a 3 month prescription , with refills enough to last for a whole year. I do not have to see them again, unless my heart goes whacko on me , which is fine with me.

    The new doctor that I am seeing is helping to adjust my thyroid medication, and she checks it every 3 months, so I am fine about seeing her that often, because once she does lab tests, she adjusts the Armour Thyroid that I take . As my thyroid is getting better, I am needing less and less of the medication, which is good.

    I think that there is probably a line somewhere between seeing patients too often just to bill medicare (or other insurance), and not seeing them enough, and then being in trouble for not discovering something that went wrong with the patient, and being sued. Have the patient come in more often seems to work for both of those things.
     
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  6. John Brunner

    John Brunner Senior Staff
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    Yeh, the impact of lawyers and patients who think they've hit the lottery has not really been a component of our conversations regarding the medical industry. We seem to beat on doctors and on insurance companies when there's that group we hate even more! I guess we all need to trust our instincts with our individual doctor relationships, huh? But for every person who blindly trusts, you got someone like me who says "...but verify."

    I'm glad your thyroid is improving! Man, that's such good news from you all the way around. My mother and both my sisters had their thyroids irradiated and went on Synthroid as a forever med. Thyroid issues seems to be pretty common in women. I'm glad your numbers are moving in the right direction.
     
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