It's happening, doctor opting out of Medicare

[axeman462]

Thanks for calling the offices and sharing their feedback.

As far as Medicare red tape creating unsustainable overhead, can you explain (can they explain?) what that means to a physician office in a way that would be unique and isolated to OM compared to MA?

I believe I have heard the humana rep saying docs who billed via MAPD PPO would get 120% of Medicare rates contractually for office visits...is that correct, and consistent accross other MAPD carriers?

I am definitely concerned about my clients losing access to doctors because OM reimbursement is so low. I used to think the sheer volume of OM members and less hassle for reimbursement would offset the lower rates, at least from a provider perspective.

I know that many MAPD plans do pay more than OM, especially PPOs, which is why some doctors only accept PPOs. Which ones they are, and by how much, I am not sure.

As for the red tape with Medicare, I am trying to avoid having myself run down a rabbit hole, but this quickly becoming a real interest for me. When I was talking to the billing lady at the one doctor office, she mentioned there was something like 132,000 regulations from Medicare that the physician's office has to follow (I'm sure she was exaggerating, but her point was taken nonetheless).

This is not something I am super concerned about just yet, but it is something that is on my radar.

 

[axeman462]

Not sure what you mean by this reply to Robrert's statement that in South GA doctors are encoraging OM over MA. I know in my area of East Tennesse that is also the case. I was considering changing to an MA and all my doctors advised my keeping OM and my supplement.

unclog your ears, and open your eyes. Your minds are dull and slow to perceive.

 

[rousemark]

unclog your ears, and open your eyes. Your minds are dull and slow to perceive.

That still does not make sense. Dr reccomend what they reccomend. Not all Drs. in all areas reccomend the same. It would appear you are the one that are slow to perceive.

 

[axeman462]

That still does not make sense. Dr reccomend what they reccomend. Not all Drs. in all areas reccomend the same. It would appear you are the one that are slow to perceive.

lol

 

[rmhaire]

A fool's way is right in his own eyes,
but whoever listens to counsel is wise.

Not sure why quoting Proverbs 12:15 has to do with my post. I was simply stating the facts as they are here in GA.

Maybe it's geography. Maybe it's politics. Or maybe it's both.

 

[axeman462]

Not sure why quoting Proverbs 12:15 has to do with my post. I was simply stating the facts as they are here in GA.

Maybe it's geography. Maybe it's politics. Or maybe it's both.

If you don't understand what that means, then I can't help you. It is obviously falling on deaf ears.

 

[rmhaire]

If you don't understand what that means, then I can't help you. It is obviously falling on deaf ears.

Of course I know what it means. I also know that you're taking Proverbs out of context.

I can assure you that my ears are just fine. But it's beginning to look like one of us has a preconceived agenda. And it ain't me.

 

[Midlevel]

Not sure what you mean by this reply to Robrert's statement that in South GA doctors are encoraging OM over MA. I know in my area of East Tennesse that is also the case. I was considering changing to an MA and all my doctors advised my keeping OM and my supplement.

Gosh, I wonder why all the Drs advised you to do that? Where Drs will really get hit hard is if OM actually starts looking at claims and puts a stop to the free for all that is OM. Then they will be telling patients MA plans are the only way to go. Don’t let them fool you, it’s about their best interests not yours. Luckily most people can see through their BS and actually think for themselves.

 

[axeman462]

Of course I know what it means. I also know that you're taking Proverbs out of context.

I can assure you that my ears are just fine. But it's beginning to look like one of us has a preconceived agenda. And it ain't me.

Yeah, I don't think you do truly understand it, otherwise you would be acting differently.

And as far as an agenda, yes I have an agenda. To unbiasedly do what's right for the customer. Certain one trick pony agents here, can't say the same.

 

[rousemark]

Yeah, I don't think you do truly understand it, otherwise you would be acting differently.

And as far as an agenda, yes I have an agenda. To unbiasedly do what's right for the customer. Certain one trick pony agents here, can't say the same.

But what does that have to do with what doctors reccomend?