Co-pays

Here's the thing. Pay your co-pay. And if you are not asked to pay a co-pay, ask to pay it.

Co-pays are an agreement between the insurance company and the patient. The insurance company agrees to cover the service as long as the patient pays his or her part.....which is the co-pay.

Refuse to pay the co-pay and, as a patient, you are in violation of the agreement you have made with your insurance company. This has nothing to do with the front desk staff or your doctor. The office staff just offers a convenient way to pay your co-pay instead of mailing it directly to your insurance company.

So next time, refuse to pay your co-pay, or say "I don't have my wallet with me today." I dare (actually encourage) front desk staff to reply, "That's fine, Mr. Tightwad, I will be happy to call your insurance company and inform them of your neglect in meeting your part of the financial obligation of your contract."

Whoa. Would just love that. Especially for Medicaid patients who are 'current every day smokers' but can't seem to scratch up three bucks for a co-pay.

Negative, Ghost Rider......

Your visit was supposed to be a  physical and covered at 100%?!? 

You don't say! I'll get right on re-coding that for you and submit a corrected claim to your insurance!

Or, not.

Let's review. Your appointment was scheduled as a new patient visit. Your chief complain was sore throat and infected toe. We did an appropriate physical exam to evaluate your symptoms, ran a rapid strep, and prescribed an anti-fungal pending labs on the liver.

Nothing routine here, sparky. Pay up.

Dragon Strike

In a note today:

The patient is doing well on the amateur plane so we will continue to monitor the dosage and effectiveness.

Hmmmm.......not sure I can count that as med management in your medical decision making.

Obese vs. Smoking

I am truly tired of two things:

1. The grant paid studies that I read that are STILL talking about the impacts of smoking.
2. The grant paid studies I read that we need to help the obese.

Look, back in the day, I smoked. We are talking 80's here. As the years rolled by there were less and less places I could smoke. Plus, it was socially encumbering because the new friends I met did not smoke. People would sneer at me in public, walk by waving their hands in front of their faces clearly disgusted by the smell. The enjoyment of nicotine was purely selfish on my part and that enjoyment was clearly aggravating my fellow society members. Then there was the cost and the negative health issues....so I quit.

Yet still, decades later, there are studies that I read about the impact of smoking. Just the other day I read a study on Med Page that talked about the impact of children seeing smoking on television and how likely the viewing was to make the child inclined to smoke. Two words: OLD NEWS. We've been down that path. We get it. The smoking population is down to 18% according to the CDC. But are we talking about the bowl of chips those children are munching down on while they watch TV? What about the big glass of soda? Nope.I mean we are talking about it, but we aren't talking about it in any meaningful way.

Now, obesity. The new smoking? Ahhh yes. It's not much different. I don't need to help the obese people find a way to lose weight. I don't need to be empathetic. No one was empathetic to me when I smoked. We don't need to legislate and outlaw the consumption of fast food and super-sized soft drinks. All we need to do is sneer at the obese in public, look on in disgust at an obese family in the local fast food joint, and ask to be moved to another table at a buffet so we don't have to be subject to the orgy of gluttony. In short, we have to make being obese just as socially unacceptable and encumbering as smoking once was (and still is).

Obesity is a huge problem. Thirty six percent of the adult population is obese according to the CDC. Yet we coddle the obese. No one wants to talk about it and be direct. Why? because we don't want to hurt someone feelings. Calling someone fat is rude I guess. But telling someone they smell like an ashtray isn't. I don't get that one.

Providers, in vain, make referrals to weight management. Those referrals go unscheduled and ignored by the patient. There is no real effort to reel obesity in and target the obese. There is no accountability.

As a society, we need to jump on this fast. We don't need to sit around and wait until obesity is more rampant than it is now. Let's not wait decades like we did with smoking to do something about it. There needs to be hard core counseling going on during office visits. There needs to be consequences that hit the wallet like the higher premiums smokers pay.

First, I'd throw in BMI. Too high? A year later still the same or higher? You now have a surcharge on your premiums to offset your higher risk and healthcare costs due to diabetes, hypertension, DJD, and my favorite, chronic back pain. Also, bye bye Medicaid/Medicare. People cannot continue bad health behaviors and receive free healthcare. Sorry. Not on my dime.

This country needs serious solutions. Not just studies and lip service.

In the beginning.....

W59.22XA

My 17 year old son came up behind me while I was staring at this previously blank page and started to rub my shoulders. He said, "Struck by a Turtle? What's that?" I told him it's a medical code that further illustrates the method by which a patient presents for an injury. I explained that I wanted to create a blog about the ridiculousness of the healthcare industry and it seemed like a good name to start with. He agreed and said, "Well that is stupid. Turtles don't move fast enough to cause anyone an injury.....unless it was thrown or kicked up by a fast moving car. In which case, I think the turtle's injury would be greater than the person's. Is anyone thinking about the turtle?"

Smart boy. I smiled, and started typing. Then I clicked "publish". So a blog was born.