tag:blogger.com,1999:blog-11336670.post5509260973493402113..comments2024-03-13T03:24:01.167-04:00Comments on Marginalizing Morons: Sticking It In Our...CaptiousNuthttp://www.blogger.com/profile/14440029537418230507noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-11336670.post-47361704123325474062009-10-25T20:05:58.578-04:002009-10-25T20:05:58.578-04:00The doc is not getting 175 bucks for the test.. th...The doc is not getting 175 bucks for the test.. that's BS... <br />That RN is being ridiculous.<br />Here's the billing deal... there are 2 parts to every bill generated... a facility fee (ie, hospital) and "professional" fee which is what the provider gets...<br />There are specific codes for a health care encounter; we have 5 basic codes in emergency medicine denoting the complexity of the case and the "work" it required.... same thing for an outpatient visit, in this case a pediatric visit.<br />Now ordering a test may move a visit code up a notch (from a "level 2" visit to a "level 3") which in the outpatient world means maybe 10-15 bucks I'm guessing...<br />The amt of $ paid for each code varies for each insurance plan, is tagged to the medicare rate (at least for all pts in ED; a common third party insurance company like BC/BS paying 115% of what medicare would pay and is subject to negotiation between the hospital, physician group, etc.<br />Now the pediatrician for that kind of visit is probably getting 30-40 bucks.. <br />Pediatricians in Boston area earning in the 100k range (for 11 years of schooling and maybe 250k in debt.. principal mind you, that has perhaps grown to over 300k by the time they start to pay it down... at the earliest, age 29-30). Anyone want to sign up for that cashcow profession?!<br />Now I know there are doctor jobs out there where the bill can be padded... I'm very skeptical about the dermatologist that biopsied 17 (seventeen!) of my 30 yo sister's moles.. the surgeons that are making ridiculous money lasering everyone and their mother's varicose veins (with some sketchy medical necessity statements to insurance companies)... but the vast majority of docs I know are not doing it to shake the system down for $.<br />In short, areas where "billable procedures" are done are the areas where abuse can happen. A pediatrician taking a flu swab is not in this category.<br />Now I totally agree with the RN statement questioning the medicine behind the test, "actionability" of it. No tests need to be done for viral illnesses. If the kid clinically has the flu and is significantly ill (a <1-2% event so far in this flu season) , just treat them! All others, send home with "reassurance". Understand that perhaps the mom is this case wanted testing (I don't know why people think tests replace clinical judgement) or maybe the doc felt he/she had to do something. Either way, it's an unneeded expense.Markhttps://www.blogger.com/profile/02052129720811266400noreply@blogger.comtag:blogger.com,1999:blog-11336670.post-40014833501710797212009-10-24T15:17:32.316-04:002009-10-24T15:17:32.316-04:00I don't remember it being called *civics*.
I&...I don't remember it being called *civics*.<br /><br />I'm not that old!CaptiousNuthttps://www.blogger.com/profile/14440029537418230507noreply@blogger.comtag:blogger.com,1999:blog-11336670.post-24641163489979593052009-10-24T01:32:56.804-04:002009-10-24T01:32:56.804-04:00C,
Doctors are more noble than us because they ta...C,<br /><br />Doctors are more noble than us because they take the Hypocritic Oath.<br /><br />Just like govt employees and politicians are more selfless than us because they only join govt to work towards the Common Good.<br /><br />Apparently you have never taken high school civics.Taylor Conanthttps://www.blogger.com/profile/18270678440957992085noreply@blogger.com