At first....this blog was meant to illustrate a play-by-play on my "Daily Experiences and interactions with Life, Death and Dying at the ER and Hospice House"...
But since my dreams have become extremely detailed and I have been having amazingly strange, yet coincidental experiences lately....I'm giving this blog the best current real-time experiences of my life.
Ask me anything!
Well, the $2 copay is just the amount that the patient is expected to pay out-of-pocket at the time of the visit. I/my medical group can then submit a bill for the total "services provided" to the insurance company -- but the state insurances never pay the full amount billed, so every state insurance patient we see is a financial loss. *sigh* Nope, doctors aren't in it for the money, cuz there ISN'T ANY.
I used to be a medical biller and certified coder and I am aware of copays, which help share some kind of cost for services. However, $2.00 barely covers the cost the the water cooler people drink from while waiting in the waiting room. The insurance payers are using Medicare as a guideline/bible to standardize their costs for your geographic location. However, if you are in a rural area, you get more $ but if you’re in a city where you compete with tons of other offices, it becomes less. The only problem I have is as an urgent care facility, you have more traffic which in turn means potentially more malpractice issues (ratio of occurance to patient’s running through there) and the reimbursement is based on several factors, one of which is the potential cost associated with malpractice insurance which if they are paying you $40 out of a $120 evaluation, one would think they don’t see any risks involved with your office procedure and pay you just to keep your facility running. My problem and question is….how does a facility make money? Is it through the prescription of pharmaceuticals or other factors?
