United World and United of Omaha 2011 Inforce Business Increase?

[somarco]

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

Some PCP's may in fact gross $700k per year or possibly more but gross and net after taxes and expenses are not the same.

Class envy about doc paychecks has been around for a while but it is really the specialists that are making pretty good money.

 

[Frank Stastny]

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

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!

I didn't "miss" anything. Nor did I say that they put the full amount in their pocket. Don't all business have expenses? I guess I assumed all business people would know that. One can cover a lot of expenses making 3/4 of a million each year. Some doctors will have a higher overhead than others. Student loans are not for life.

Why are insurance agents so concerned about how much doctors make? I've never seen one standing by an interstate exit holding a sign saying they will give colon exams for food.

All of the doctors we associate with are doing quite well for themselves. Maybe you know different and only "poor" doctors.

Doctors don't care how much insurance agents make and we have expenses as well. Some even have student loans that they are paying off.

 

[Newby]

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

It's not a matter of doctors making too mich or too little or anything in between.
It's a matter of a person in business for themself should be able to charge what they want to charge.
In a perfect world (in my opinion) doctors should be required to have standardized general price lists (similar to what funeral homes are required to have) and people could easily tell if their doctor at the lower price range, the middle or at the upper end.
Then if a patient CHOOSES to go with a doctor that charges more, Medicare should pay what they normally pay and the patient pays the difference over and above what his supplement covers.
It shouldn't be possible that the government has so much control over private business (doctors) that they can say "if you don't charge what we want you to charge then you get ZERO from Medicare.
I do think there should be full disclosure to the patient up front in the form of standardized price lists and a disclosure that has one of three statements on it 1. This office accepts Medicare assignment as payment in full. 2 . This office bills at 10% over the Medicare amounts (or whatever the % for the excess charges allows.). Or #3 This office is priced higher than Medicare guidelines allow. You will owe additional money over and above the amounts covered by your Medicare and supplemental coverage will pay.
That is how a free society should work. A provider should be required to provide the consumer with the information they need to make an intelligent decision. The government should NEVER be allied to CONTROL what a private business person charges.

 

[somarco]

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

At the risk of getting this off track, transparency only works where there is uniformity in the product.

Humans are complex, making it impossible to price anything beyond the basic procedure on a price list.

Second, who looks for the cheapest doc when their health is at stake?

Third, since we have created a copay society, why should anyone really care what the actual cost of a procedure is since they are never going to pay it?

 

[Russ]

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

I think doctors should be allowed to charge a higher excess charge that they can collect on, under Medicare. That might stop some from leaving the system.

If it's a good doctor then some patients would be willing to pay, if needed. A persons health is more important than paying additional excess charges.

The system is in a free-fall and needs fixing. I agree that cuts will have to be made to Medicare, Medicaid and Social Security. There's really no choice and doing nothing now will make it worse in the future.

 

[medx]

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

I think doctors should be allowed to charge a higher excess charge that they can collect on, under Medicare. That might stop some from leaving the system.

If it's a good doctor then some patients would be willing to pay, if needed. A persons health is more important than paying additional excess charges.

The system is in a free-fall and needs fixing. I agree that cuts will have to be made to Medicare, Medicaid and Social Security. There's really no choice and doing nothing now will make it worse in the future.

I agree. Something needs to be done to keep many Doctors who are no longer accepting new medicare patients.

 

[somarco]

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

Something needs to be done to keep many Doctors who are no longer excepting new medicare patients.

Already exists.

It is called . . . cash.

 

[arnguy]

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

I agree. Something needs to be done to keep many Doctors who are no longer excepting new medicare patients.

You must mean "accepting..." There may be some exceptions.

 

[azmedsupagent]

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

Review one of your clients EOB's and compare the 'Medicare Allowed charges' for the last 5 yrs. Trust me...they have them or, at least, most of them do.
M/C allowed/approved amounts have dropped. In 2004, M/C was approving/allowing around 70% of the doctor's charges..now it's more like 50%. Now I work in the hills of Arkansas (love it!!) however there are doctor's here who do not accept assignment and more going that route. Why? Because they do not have to accept the terms. The doctor's can charge up to 15% above the M/C allowed amount.

For example: surgery, doctor charge $10,000. Medicare approves, say, 60%. That's $6,000. M/C pay 80%, which is, $4800. If Dr. accepts assignment, he gets paid $1200. If he doesn't accept M/C assignment, he can collect up to $2100.

With that said..when M/C cuts down on the allowed or approved amount to the doctors then more doctors will not accept M/C assignment. They are and will charge the excess charges. They already are in my lil ole' state of Arkansas.

Plan F cover excess...Plan D do not. Plan F have higher premium increases every year than Plan D. I always explain to my client the differences in coverage, in premium and the difference in increases. 90% want Plan F. If they want Plan D....sold!! but that is rare.

Correct me if I am wrong but I know this is true with 2 companies I have....Seniors have to qualify to add benefits, say, a Plan D to Plan F. They do not have to qualify to get fewer benefits, Plan F to Plan D. Wouldnt you want to be protected??

And this is why I sell plan G!

 

[GreenSky]

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

For example: surgery, doctor charge $10,000. Medicare approves, say, 60%. That's $6,000. M/C pay 80%, which is, $4800. If Dr. accepts assignment, he gets paid $1200. If he doesn't accept M/C assignment, he can collect up to $2100.

Two problems:

1) If they could charge 15% of the total allowable, you would be correct. But they can olnly charge 15% of 95%, so in the above example the doctor will receive a total of $5,244, which is an extra $444.

2) They now must collect the entire $5,244 from the patient. Neither Medicare nor the supplement will not pay them directly but all money goes to the patient. How much does this surgeon collect when the patient dies?

Excess charges have been sold via Plan F using fear to make the sale. Explain this correctly and your clients will thank you for the education and somelike like me won't come behind you and rewrite your client into the "proper" plan.

Disclaimer: I still write mainly Plan F because there is virtually no differnce in cost in CA between F, D and G. But where there is a price difference (I've seen $600/yr ore more, I spend as much time as necessary to be sure my client gets the best value. And worrying about excess charges that even if in play would be less than the annual premium difference is selling fear.

Rick