“Ironically, but expectedly, the ones who do this now are likely to have supported Obamacare.”
..there is the “annual ” or “preventative” exam, which according to Obamacare is “free” ...
...and docs who accept Medicare (the vast majority) are forbidden from selectively providing free care.
What they did not tell you, and I am, is that it covers absolutely nothing more than the bare minimum.
I have now posted a notice in my office and each exam room stating exactly what Obamacare will cover for those yearly visits. Remember Obama promised this as a free exam — no co-pay, no deductible, no charge. That’s fine and dandy if you are healthy and have no complaints. However, we are obligated by law to code specifically for the reason of the visit. An annual exam is one specific code; you can not mix this with another code, say, for rectal bleeding. This annual visit covers the exam and “discussion about the status of previously diagnosed stable conditions.” That’s the exact wording under that code — insurance will not cover any new ailment under that code.
If you are here for that annual exam, you will not be covered if you want to discuss any new ailment or unstable condition. I cannot bait and switch to another code — that’s illegal. We, the physicians, are audited all the time and can lose our license for insurance fraud.
You, the patient, will then have to make a decision.
Do you want your “free” yearly exam, or do you want to pay for a visit which is coded for a particular, new problem? You can have my “free” exam if you only discuss what Obamacare wants me to discuss...
Patients can be very tricky. I have had patients make an “annual” exam, only to want to discuss and be treated for another ailment. I can’t do it...
I can hear the complaints from you guys already — I become the bad guy. “Why don’t you just take care of the problem, and not bill out any different code? You’re a rich doctor, and we are entitled to free stuff.”
It doesn’t work that way. First, doctors are not rich and, like most of you, actually work terribly hard for a living. Second, Obamacare is the law — and as I said earlier, we are audited all the time now.
Here's a report from the world of cancer care:
I am a Hematologist/Oncologist with 27 years combined training (10 yrs after college) and practice (17 yrs). I am in a large group of oncologists and we do chemotherapy in our offices, have several imaging centers and radiotherapy in two locations. Currently we employ 130 people, and pay 100% of their health care insurance premiums, as well as a matching 401k. Each physician sees approx 15 to 25 patients daily in office and 5-10 hospital patients daily. We are a busy and, at the moment, financially secure business.As with the "War on Poverty" and public education, we can expect government to waste ungodly amounts of wealth "fixing" the foreseen flaws, strengthening Obamacare's grip on our private lives but making negligible improvements in the quality of health care.
Here’s the preliminary numbers when we are paid at Medicaid reimbursement, oops I mean Obamacare rates: Half our offices will close, forcing patients to travel to a restricted number of locations. We will not be able to give chemochemotherapy in our offices, as the drug costs and nursing costs will be higher than what we will get paid, so the patients will have to get their chemo in what hospitals will still be giving chemo in an outpatient suite. In our community, just to cover the number of patients that receive chemo services in our offices, the hospitals will need to set aside 60-80 clinic slots each day. Right now there are approx 15 slots between the 7 hospitals we cover and no plans to add more, so where these patients will receive their cancer treatments, outside of a 2 hr drive to the Texas Medical Center, I don’t know.
Our staff will either be halved or go part time (29.5 hrs). How I will run a medical practice with this kind of staffing, I have no idea.
The physicians will need to see 45 cancer patients daily, yup, 45 patients with a life threatening and devastating disease like cancer, to cover overhead costs, whilst the physicians taking a 50%, likely more, pay cut.
Oh, and then there is the whole caboose of regulations that my practice will have to pay $400/hr lawyers to figure out how to keep us in compliance, since the fines are upwards of $100K per occurrence.
I don’t think the picture is any better for other specialties, but I will tell that for cancer care it is a catastrophe for the patients and the providers.
UPDATE: Linked at Gorges' Grouse and Eternity Matters. Thanks!
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