United World and United of Omaha 2011 Inforce Business Increase?

[GreenSky]

Re: United World and United of Omaha 2011 Inforce Business Increa

I think we need to be honest about the fact that physicians have had a 20 percent paycut on the table for several years now that will eventually go through when congress cant pass the doc fix another year at a cost of 250 billion dollars. Once that physicians pay cut goes through all your plan D customers are going to be in hot water.

Completely disagree. It still won't be worth the doc doing all the billing just to have Medicare pay the patient directly in order to collect a net of 9.25% more. Remember that if they do get a 23% cut then a $70 office visit is paid at $54. So they'll be "happy" to accept patients without assignment so they can collect an extra $4.99?

The reality is doctors will simply leave the profession or stop accepting Medicare entirely. When that happens, it doesn't matter if the patient has Plan D or Plan F.

The only solution to this mess is to provide each person with Medicare with a voucher so they can buy their own Medicare Advantage plan, either an HMO for next to nothing, or a PPO plan - just like the rest of us.

Rick

 

[Frank Stastny]

Re: United World and United of Omaha 2011 Inforce Business Increa

Actually for once Frank isn't 100 percent correct here. Infact the chart listed in that web link further illustrates this. If you look again you will notice that this cost break down has medicare paying 80 percent. This is implying that mayo billed part b.

The fact is that if you are an outpatient at a hospital your costs will be billed under medicare part B and therefore will be subject the excess charge.

I think we need to be honest about the fact that physicians have had a 20 percent paycut on the table for several years now that will eventually go through when congress cant pass the doc fix another year at a cost of 250 billion dollars. Once that physicians pay cut goes through all your plan D customers are going to be in hot water. Not to mention the fact that medicare is going broke incase you forgot, the baby boomers are here and the system is going to be stretched very thin. If there ever was a time to expect medicare to pay doctors less that time is now. That excess charge will be a no brainer for docs in a few years.

I'm not trying to be argumentative but, what you are referring to is Medicare Part B, not Medicare Part A. The Mayo clinic does bill Medicare Part B. Nowhere do they say that they don't.

Hospital charges are not the same as Outpatient charges. Outpatient care is not just limited to hospitals. Medicare pays 80% of Part B approved charges, period. It's what they do.

You are correct in that there has been proposed legislation for the last several years to cut physicians pay but it has never gone through. That part you can "be honest" about. However, there is nothing pending nor anything stated that it is going to happen either now or in the immediate future.

You are simply making a WAG and an assumption. I don't think anyone can make accurate projections regarding what Congress is going to do. Medicare has been "going broke" for years, do you not think that Congress will address that and probably find a fix? They have "fixed" everything else and bailed out everyone who has "asked". That is just as good a possibility as you saying that all doctors are going to stop accepting assignment.

What is never talked about is that Medicare has initiated numerous protocols that are specifically designed to enable doctors to collect more money from Medicare when they follow Medicare's protocols. Medicare is aware of doctors wanting more money and has been addressing that.

I just looked out the window and the sky is still where it is suppose to be. It isn't falling yet.

 

[azmedsupagent]

Re: United World and United of Omaha 2011 Inforce Business Increa

I'm not trying to be argumentative but, what you are referring to is Medicare Part B, not Medicare Part A. The Mayo clinic does bill Medicare Part B. Nowhere do they say that they don't.

Hospital charges are not the same as Outpatient charges. Outpatient care is not just limited to hospitals. Medicare pays 80% of Part B approved charges, period. It's what they do.

You are correct in that there has been proposed legislation for the last several years to cut physicians pay but it has never gone through. That part you can "be honest" about. However, there is nothing pending nor anything stated that it is going to happen either now or in the immediate future.

You are simply making a WAG and an assumption. I don't think anyone can make accurate projections regarding what Congress is going to do. Medicare has been "going broke" for years, do you not think that Congress will address that and probably find a fix? They have "fixed" everything else and bailed out everyone who has "asked". That is just as good a possibility as you saying that all doctors are going to stop accepting assignment.

What is never talked about is that Medicare has initiated numerous protocols that are specifically designed to enable doctors to collect more money from Medicare when they follow Medicare's protocols. Medicare is aware of doctors wanting more money and has been addressing that.

I just looked out the window and the sky is still where it is suppose to be. It isn't falling yet.

Well Frank your bullish and im bearish i guess. Mark my words though, the cuts are coming.

"Medicare has been "going broke" for years, do you not think that Congress will address that and probably find a fix?"

Yes they will find a fix! its called higher deductibles, higher part b premiums and physicians payment cuts! Thank you for inadvertently proving my point.

Now if you'll take a second to do some looking around what you will find is that the last physicians pay cut was only a fix through 2011. That means this issue is up again in under a year. Lets consider the fact that our country is officially bankrupt and our debt is almost the size of our entire economy, do you really think that this republican senate is going to let another 250 billion 2 year patch pass again? I dont think so my friend. The cuts are coming.

 

[Newby]

Re: United World and United of Omaha 2011 Inforce Business Increa

Completely disagree. It still won't be worth the doc doing all the billing just to have Medicare pay the patient directly in order to collect a net of 9.25% more. Remember that if they do get a 23% cut then a $70 office visit is paid at $54. So they'll be "happy" to accept patients without assignment so they can collect an extra $4.99?

The reality is doctors will simply leave the profession or stop accepting Medicare entirely. When that happens, it doesn't matter if the patient has Plan D or Plan F.

The only solution to this mess is to provide each person with Medicare with a voucher so they can buy their own Medicare Advantage plan, either an HMO for next to nothing, or a PPO plan - just like the rest of us.

Rick

I'm not totally clear on the $4.99 extra for the doc. Is the doc not allowed to charge $90 for instance, not take Medicare assignment and make the patient pay $90? Then the patient gets reimbursed directly from Medicare at $54 plus $4.99 and had the extra amount out of his pocket.

Is that not allowed? If it is, I could definitely see doctors doing that if the politicians try to squeeze them further.

 

[GreenSky]

Re: United World and United of Omaha 2011 Inforce Business Increa

I'm not totally clear on the $4.99 extra for the doc. Is the doc not allowed to charge $90 for instance, not take Medicare assignment and make the patient pay $90? Then the patient gets reimbursed directly from Medicare at $54 plus $4.99 and had the extra amount out of his pocket.

Is that not allowed? If it is, I could definitely see doctors doing that if the politicians try to squeeze them further.

It is not allowed although some docs are "dirty."

If you accept Medicare, you must accept the Medicare fee schedule. So in the above case, the doctor could charge $90 but if the schedule says $54, that's all he can get if he accepts assignment. He can charge up to 15% of 95% (which is 9.25% more than 100%) if he won't take assignment. That's how he can get $4.99 additional.

Pretty lousy return considering he still has to bill Medicare, wait for the patient to be paid by both Medicare and the supplement, and hope that he then gets paid the entire amount of $59 by the patient. All that to earn under $5!

Rick

 

[somarco]

Re: United World and United of Omaha 2011 Inforce Business Increa

Tax Report: Where Do Your Tax Dollars Go? - WSJ.com

38% of the federal budget is for SS, Medicare, Medicaid.

Eliminating pork, freezing pay raises, blah, blah won't get the job done. Once interest rates start to rise the interest owed on the debt will pick up steam.

If Congress is serious about reducing spending they have got to make cuts in the top three money holes.

We now return you to your regular programming.

 

[Frank Stastny]

Re: United World and United of Omaha 2011 Inforce Business Increa

It is not allowed although some docs are "dirty."

If you accept Medicare, you must accept the Medicare fee schedule. So in the above case, the doctor could charge $90 but if the schedule says $54, that's all he can get if he accepts assignment. He can charge up to 15% of 95% (which is 9.25% more than 100%) if he won't take assignment. That's how he can get $4.99 additional.

Pretty lousy return considering he still has to bill Medicare, wait for the patient to be paid by both Medicare and the supplement, and hope that he then gets paid the entire amount of $59 by the patient. All that to earn under $5!

Rick

I think you are forgetting that if the doctor accepts assignment both Medicare and the insurance company send the check directly to the doctor in a timely fashion.

Where is it written that the doctor is entitled to or has earned the full $90? Just because that is what he had decided to charge?

Most the time when I go see a doctor he may spend as much as 15 minutes, usually a lot less, in the exam room with me. The vitals and information, etc are done by a medical assistant most of the time.

Even at 15 minutes per appointment, that's four appointments at $59 or $236 per hour. Or $1,888 per day. If he is seeing 50 patients a day, much more common, that is $2,950 per day. Remember, it is doubtful that 100% of the doctors patients are all going to be on Medicare.

But even at only $2,950 per day for 260 days per year the doctor is making $767,000 per year. Is that what people consider "going broke" and that doctors can't afford to treat a patient when they are only making $767,000 per year?

Most doctors schedule between 40 and 60 patients a day, not just 32. If a doctor is only seeing 30 patients a day he is considered a "slacker" by other doctors or he is a new doctor building a practice.

 

[GreenSky]

Re: United World and United of Omaha 2011 Inforce Business Increa

I think you are forgetting that if the doctor accepts assignment both Medicare and the insurance company send the check directly to the doctor in a timely fashion.

I think I pointed out multiple times that if a doc does NOT accept assignment the patient is paid. Did I need to spell out the opposite if they do accept assignment?

Rick

 

[Frank Stastny]

Re: United World and United of Omaha 2011 Inforce Business Increa

I think I pointed out multiple times that if a doc does NOT accept assignment the patient is paid. Did I need to spell out the opposite if they do accept assignment?

Rick

That was a "test".

 

[azmedsupagent]

Re: United World and United of Omaha 2011 Inforce Business Increa

I think you are forgetting that if the doctor accepts assignment both Medicare and the insurance company send the check directly to the doctor in a timely fashion.

Where is it written that the doctor is entitled to or has earned the full $90? Just because that is what he had decided to charge?

Most the time when I go see a doctor he may spend as much as 15 minutes, usually a lot less, in the exam room with me. The vitals and information, etc are done by a medical assistant most of the time.

Even at 15 minutes per appointment, that's four appointments at $59 or $236 per hour. Or $1,888 per day. If he is seeing 50 patients a day, much more common, that is $2,950 per day. Remember, it is doubtful that 100% of the doctors patients are all going to be on Medicare.

But even at only $2,950 per day for 260 days per year the doctor is making $767,000 per year. Is that what people consider "going broke" and that doctors can't afford to treat a patient when they are only making $767,000 per year?

Most doctors schedule between 40 and 60 patients a day, not just 32. If a doctor is only seeing 30 patients a day he is considered a "slacker" by other doctors or he is a new doctor building a practice.

Nice cost breakdown... except for the fact your missing the other half of the story. Your 700k number is just gross revenue. What about things like rent, payroll, employee health insurance, depreciation, equipment, supplies, malpractice insurance etc. That should chop that 700k number down to size right? Oh wait I forgot 150k + in student loan payments!