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Maintence Fee for the Priveledge of seeing a Dr

Health Care 2005

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#1 darthsikle

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Posted 27 October 2005 - 01:35 PM

My pediatrician just sent me a letter informing me that due to the high cost of insurance, I would be assessed a maintence fee of $60 per child for the priveledge of having him as my periatrician.  I kid you not.  This is not covered my medical insurance.  The letter goes on to say that if I choose not to pay it, he would no longer have us as patients.

With three daughters, thats $180 a year.  Unreal.
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#2 Rhea

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Posted 27 October 2005 - 01:43 PM

darthsikle, on Oct 27 2005, 10:35 AM, said:

My pediatrician just sent me a letter informing me that due to the high cost of insurance, I would be assessed a maintence fee of $60 per child for the priveledge of having him as my periatrician.  I kid you not.  This is not covered my medical insurance.  The letter goes on to say that if I choose not to pay it, he would no longer have us as patients.

With three daughters, thats $180 a year.  Unreal.

<{POST_SNAPBACK}>


It's particularly ridiculous given that, as I found out recently, if a doctor works with an HMO they get a certain amount of money per month WHETHER THEY SEE THE PATIENT OR NOT!
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#3 Tom Sawyer

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Posted 27 October 2005 - 01:59 PM

I could see perhaps a $10 charge on each kid for record keeping fees and all that.  But $60 per head for simply being physician of record?

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#4 darthsikle

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Posted 27 October 2005 - 02:15 PM

The ex wife was all like, we can't switch doctors, they've been seeing the kids since birth...etc etc

I was like, OK, I have my $30 per kid.

Ohhh, she said, I dont have any money.  You have to pay for it.

Uggghhh!!!
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#5 Natolii

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Posted 27 October 2005 - 03:24 PM

darthsikle, on Oct 27 2005, 03:15 PM, said:

The ex wife was all like, we can't switch doctors, they've been seeing the kids since birth...etc etc

I was like, OK, I have my $30 per kid.

Ohhh, she said, I dont have any money.  You have to pay for it.

Uggghhh!!!

<{POST_SNAPBACK}>



I'm assuming that she has custody, Darth? In that case, Child support should cover it. The fact you are willing to contribute more to offset the cost is more than generous.

If I were you, I would a) check into the Legalities of this Fee and b) find another Pediatrian. I have been with the same practice since I was a child (My daughter's now a patient) but if they were to start charging such fees, I would not hestiate to find another practice.
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#6 Eskaminzim

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Posted 27 October 2005 - 04:17 PM

Darth:

Question.  Do you have an HMO as your insurance?

If so, what the doctor is doing is 100% no-holds-barred no-if-ands-or-buts illegal.  The physician is under contract by the HMO to provide services to its customers for a pre set fee.  It is illegal to balance bill or to charge any patient any more than their already established (through the HMO) co-pay.  Period.  

I'd call your insurance company's customer service number and report the physician doing this. The DOI (Department of Insurance) with your state will no doubt be very interested since this is a hot button issue right now and there are docs getting indicted left and right for this very thing.

Of course, that's only if you have an HMO.

Again, if your insurance is an HMO, it is ILLEGAL for the physician to drop you from his/her patient roster if you don't come up with illegal funds not granted under his/her contract with the HMO.

#7 Eclipse

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Posted 27 October 2005 - 07:35 PM

hmmm ... methinks this practice smacks of racketeering.

this is just another adaptation of the old "protection racket"
(pay up if ya wanna stay healthy, chum)

ask your local prosecutor to invoke the RICO act against this thug!


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#8 Natolii

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Posted 27 October 2005 - 07:38 PM

And if it is not illegal, it is certain inethical...

And the Medical Profession has boards and places you can go for help.
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#9 Cheile

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Posted 27 October 2005 - 08:22 PM

i fail to see how it can be legal to charge a separate fee just to see the patient whether or not it's an HMO!  doctors make enough for the love of Rommie....they don't deserve extra money the way Darth is talking for nothing. :grr:

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#10 Shalamar

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Posted 27 October 2005 - 08:35 PM

I agree with every one else - this is quite possibly completely illegal and darn unethical. It stinks of racketeering to me.
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#11 darthsikle

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Posted 27 October 2005 - 09:18 PM

Natolii, on Oct 27 2005, 08:24 PM, said:

I'm assuming that she has custody, Darth? In that case, Child support should cover it. The fact you are willing to contribute more to offset the cost is more than generous.

<{POST_SNAPBACK}>


We have joint and shared custody, however I always pay my child support + + +.  I buy all the clothes, all the medical bills, etc.  No biggie.  It just irked me to pay this.



Eskaminzim, on Oct 27 2005, 09:17 PM, said:

Darth:

Question.  Do you have an HMO as your insurance?

<{POST_SNAPBACK}>


I have a PPO.  I don't know the difference.  I mean, I know the difference in how they operate, not whether it would be legal or not.

I read about this in the Wall Street Journal a few months ago.  I read it is getting popular.
Goodbye.

#12 Nonprofit

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Posted 27 October 2005 - 09:57 PM

Sheeez....$ 60 beans seems to be the going rate for this new "extra" charge.

I know a couple folks who have been told they now have to paid this.  Even one buddy who is on disability that has medicaid.  I just gave him the money so he doesn't have to worry.  Gads,  he barely has enough to live on now with the cost of meds and such.


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#13 Cheile

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Posted 27 October 2005 - 11:50 PM

darthsikle said:

I have a PPO.  I don't know the difference.  I mean, I know the difference in how they operate, not whether it would be legal or not.

I read about this in the Wall Street Journal a few months ago.  I read it is getting popular.

<{POST_SNAPBACK}>


i say get on the phone with whomever you have the PPO with and check with them.  this cannot be legal and it's pure BS.

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#14 Broph

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Posted 28 October 2005 - 06:36 AM

You figure the average doctor has 1,000 patients (4 patients a day for physicals, 250 days a year), just to keep things round. At $60 per, that's $60,000 above and beyond what they charge for services. That probably pays for a receptionist and puts some money towards a nurse/practitioner.

#15 Rhea

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Posted 28 October 2005 - 11:20 AM

Broph, on Oct 28 2005, 03:36 AM, said:

You figure the average doctor has 1,000 patients (4 patients a day for physicals, 250 days a year), just to keep things round. At $60 per, that's $60,000 above and beyond what they charge for services. That probably pays for a receptionist and puts some money towards a nurse/practitioner.

<{POST_SNAPBACK}>


Most doctors see WAY more than 4 patients a day - more like a patient every 1/2 hour, at least.
The future is better than the past. Despite the crepehangers, romanticists, and anti-intellectuals, the world steadily grows better because the human mind, applying itself to environment, makes it better. With hands...with tools...with horse sense and science and engineering.
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When I don’t understand, I have an unbearable itch to know why. - RAH


Everything is theoretically impossible, until it is done. One could write a history of science in reverse by assembling the solemn pronouncements of highest authority about what could not be done and could never happen.  - RAH

#16 Appreciate

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Posted 28 October 2005 - 12:04 PM

^^Iirc they have to see SIX patients per hour.

Darth, that really is awful.  I hope you can fight it and I hope it does not spread.

Has anyone run across this thing called "executive medicine"?

In Texas, for example, a group offers the ambassador and diplomat levels of executive health care.  The cost for a COUPLE is $5500 for Ambassador and $14,500 for Diplomat, annually.

Here in California, such services are pricier:  about $20,000 annually per each patient.  The kicker is that this is just another of the CEO perks that one continues to read about, in that the name and marketing is pitched to companies purchasing this insurance "to save the time of the busy executives."  Mid level managers, factory floor workers, janitors need not apply unless they can cough up those bucks.

We're not just in a two-tiered health coverage world, it's three-tiered:  Executives, who get the very best care, normal working stiffs, who at least have insurance, and those who have no insurance at all.

I am appalled but this but then, I'm not an executive, am I?

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#17 rponiarski

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Posted 31 October 2005 - 02:32 PM

Eskaminzim, on Oct 27 2005, 05:17 PM, said:

Darth:Again, if your insurance is an HMO, it is ILLEGAL for the physician to drop you from his/her patient roster if you don't come up with illegal funds not granted under his/her contract with the HMO.

<{POST_SNAPBACK}>


Not all the time. Depends upon the contract that a doctor signed with an insurance company. Plus, the agreement can be terminated by either side, for any number of reasons. Also, not all insurance companies work on a capitation model (paid for each member seen on a yearly basis). Many are now going to a more visit/procedure based system, which may allow them to charge additional fees and co-pays.

I am not sure what Darth's coverage is, but that $60 probably doesn't even cover one biller for a year in my neighborhood.
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#18 rponiarski

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Posted 31 October 2005 - 02:41 PM

Cheile, on Oct 27 2005, 09:22 PM, said:

i fail to see how it can be legal to charge a separate fee just to see the patient whether or not it's an HMO!  doctors make enough for the love of Rommie....they don't deserve extra money the way Darth is talking for nothing. :grr:

<{POST_SNAPBACK}>


Really, how do you figure that? A doctor goes to college, medical school and comes out owing about $300,000 dollars these days. Then there is residency, in which you work 120 hours a week for about $21,000/year. Not peanuts, but not a lot either. Then you actually may begin to earn a living, and not a great one anymore. The average doctor's income has been going down for the last 10 years at least, and it's bound to get even worse in the near future. More work for less money and less satisfaction; not a great career choice these days. Add in malpractice costs (a pediatrician pays near to $100,000 PER YEAR in New York and can be sued until the child is 18) and things go from bad to worse.

I will grant you that in the past many doctors earned a lot of money, and some still do. I don't condone that and never will. But the majority are hard working, middle class people. Seeing things from their side may bring you a different perspective...
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#19 rponiarski

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Posted 31 October 2005 - 02:49 PM

Shalamar, on Oct 27 2005, 09:35 PM, said:

I agree with every one else - this is quite possibly completely illegal and darn unethical. It stinks of racketeering to me.

<{POST_SNAPBACK}>


How is it racketeering? Sounds like he is charging an administrative fee to cover expenses for his practice, which may or may not be allowed under his contract with the insurance company. Assuming it is, why can't he try to make a patient pay some of cost? If he would have raised his rates, perfectly legal, and dropped seeing people from that insurance carrier, also perfectly legal, would you still say it is unethical and racketeering?

A doctor is not obliged to care for anyone who can't pay his fee, except in an emergency. He can say no for any reason, or no reason at all. You don't like it, seek another doctor. Simple. There are a lot of choices out there...
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#20 darthsikle

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Posted 31 October 2005 - 03:19 PM

No one asked him to go to school.  He chose to do it.  I look at Dr's financials every day of the week to rent them space.  I'm tired of hearing how a Dr's insurance tripled from $100,000 to $300,000 per year.  Bid deal.  The firm's PROFITS dropped from $1.7M to $1.5M.  Poor babies....
Goodbye.



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