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  #1  
Old 01-12-2007, 08:22 AM
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Should have done better in school

Last month I saw my Doctor because I was afraid I had fractured my foot. Ten minutes later he told me I had a subluxation of the cuboid bone. It righted itself after a week. The bill? $230. That's almost $1400/hr. Yeah yeah, I know, overhead, insurance, etc. But boy does that seem like a lot of dough.

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Old 01-12-2007, 08:26 AM
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I need to make $1000 a month. I have 100 patients. Each patient would need to pay $10. If 50 of the 100 don't pay, the rest have to pay $20 apiece.

You are also paying for those who don't pay.
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Old 01-12-2007, 08:33 AM
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School may have little to do with knowing how to charge for your labor.

When I make a housecall to clean,lube and adjust a tallcase clock{Grandfather to youse hooples} The minimum is $400.00 for a 2 weight,up to $650.00 for a 3 weight westminster quarter hour strike.

Don't ask how much if I have to take the movement back to the shop for bushings,ect.
I get perhaps 6-10 housecalls a month,which don't conflict with my other duties.

"If you have to ask the price you can't afford it".
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Old 01-12-2007, 08:35 AM
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That's almost as much as diagnostics at an M-B dealer!
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  #5  
Old 01-12-2007, 08:49 AM
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Quote:
Originally Posted by Kuan View Post
Last month I saw my Doctor because I was afraid I had fractured my foot. Ten minutes later he told me I had a subluxation of the cuboid bone. It righted itself after a week. The bill? $230. That's almost $1400/hr. Yeah yeah, I know, overhead, insurance, etc. But boy does that seem like a lot of dough.
This help the good Dr. repay his $400,000 in student loans he has out over his eight years of schooling.
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  #6  
Old 01-12-2007, 08:57 AM
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I need to make $1000 a month. I have 100 patients. Each patient would need to pay $10. If 50 of the 100 don't pay, the rest have to pay $20 apiece.

You are also paying for those who don't pay.
Trust me everybody pays my Doc. He's the team Doctor for the Minnesota Thunder and, on occasion, the attending physician for the US nordic ski team.

My wife separated her shoulder and the X-rays were $600! Plus he saw her on the spot gratis the day she hurt herself.
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Old 01-12-2007, 08:59 AM
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I represent only physicians and I used to be of the same mindset. Now though I have seen the way their reimbursements are generally out of their control. A $1400 procedure might be reimbursed by private insurance or Medicare at a max of around $650. I do not intend to start a big tiff here about socialized medicine and all the problems with the US healthcare system -- just my simplistic observation that it is not always as it may appear to be.

I am in the midst of trying to resolve a diagnostic study billed to my elderly Mom. Medicare and workers comp both fought about it and have so far denied payment so the provider has turned to her for the $. If Medicare/WC had paid it would have been under $600 but because they are seeking private-pay, they want $1400. I think that is inappropriate.
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Old 01-12-2007, 09:05 AM
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Originally Posted by Kuan View Post
Trust me everybody pays my Doc. He's the team Doctor for the Minnesota Thunder and, on occasion, the attending physician for the US nordic ski team.

My wife separated her shoulder and the X-rays were $600! Plus he saw her on the spot gratis the day she hurt herself.
I don't know about that doctor specifically but for the most part, that isn't true. All that has an effect on the rates. He bills at $600 but how much does he actually get back? This is like the Car dealer telling you that they are $100 above invoice. There are side channels for their income. Doctor bills at way less than that or my wife would be an MD at this time.
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  #9  
Old 01-12-2007, 09:07 AM
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If Medicare/WC had paid it would have been under $600 but because they are seeking private-pay, they want $1400. I think that is inappropriate.
Look at it this way. If you buy 1 TV set, it is $500. Buy 5000 and now you might be talking some serious change off. Difference between retail and wholesale.
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  #10  
Old 01-12-2007, 09:17 AM
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Look at it this way. If you buy 1 TV set, it is $500. Buy 5000 and now you might be talking some serious change off. Difference between retail and wholesale.
Yeah, I absolutely understand about the negotiated volume discounts -- it is the engine which drives insurance coverage. I am not pleased because they expect a fixed income, disabled retiree to throw that kind of $ around because the ordering doc did not have precertification for the work-up as had represented. And, bottom line is, the provier was fully expecting only the negotiated, discounted rate. Now they have a windfall because of the doc's oversight.
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  #11  
Old 01-12-2007, 09:26 AM
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Yeah, I absolutely understand about the negotiated volume discounts -- it is the engine which drives insurance coverage. I am not pleased because they expect a fixed income, disabled retiree to throw that kind of $ around because the ordering doc did not have precertification for the work-up as had represented. And, bottom line is, the provier was fully expecting only the negotiated, discounted rate. Now they have a windfall because of the doc's oversight.
True. However, what about the negative windfall of medicare and medicaid? You only get about 50% or less of what you bill. They have the right to reject your claims for any and all reasons. Sometimes you get told that this form is only good till Sep. Come mid Aug, there are no replacement forms. Send them in only to have them totally rejected. Processing is time. You probably get 25 cents on the dollar on the average. What about the deadbeats that they have to treat with no payments whatsoever? So, yes, there is the other side of the coin too.
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Old 01-12-2007, 10:09 AM
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My brother is a doc. Department head of the local hospital and maintains a private practice.

If he could collect 100% on his billing, he'd be a millionaire. He's not, but he's doing well financially.

His consults and office hours pretty much keep him away from home and family for 20 hours a day, 7 days a week!

Visited him and his family this Christmas. In the week we stayed, I saw my brother in person for a total of 8 hours. Totally sucky career demands and general life existence IHMO!

Be careful what you wish for!

If you didn't do well in school, you should have boned up on your athletic skills instead!

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  #13  
Old 01-12-2007, 10:47 AM
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For the most part, the general public has no clue about business or accounting. They compain about a charge, and express it in terms of dollars per hour. What they are missing is the allocation of overhead and some profit margin into the rate structure. All of the expenses for office staff, building, machine depreciation, mal-practice insurance , etc. etc. These are expenses are largely fixed. They have to be recovered by billable hours and there are only some many hours. Ever wonder why Dentists work on more than 1 patient at a time?

Ask 10 people for the definition of Net Income or Gross margin and you will get blank stares.

If I ask my consulting customers, owners of small companies (10 to 30 million in annual sales), some questions about their Income Statements, they admit that they don't really understand it in detail. They rely on their CPA's. Unfortunately, the CPA's understand taxes and little else about running a manufacturing company.

This is surely not limited to medical field. Ask the owner of almost any business dealing with the general public about how the customers squeal over the bill. You'll get an ear full.

Without going into detail, I make my living as a business consultant. When my customers, ***** about my rates, I remind them that I'm not billing 40 hours a week, and 4 weeks a month. Let's just say it's well over $100 an hour plus travel expense. Sounds great, but it's really not all that wonderful because it's not predictable.

Off my soapbox.

Steve
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  #14  
Old 01-12-2007, 10:50 AM
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Quote:
Originally Posted by Kuan View Post
Trust me everybody pays my Doc. He's the team Doctor for the Minnesota Thunder and, on occasion, the attending physician for the US nordic ski team.

My wife separated her shoulder and the X-rays were $600! Plus he saw her on the spot gratis the day she hurt herself.
The paying patients are also paying for your wife's visit.
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  #15  
Old 01-12-2007, 11:15 AM
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True. However, what about the negative windfall of medicare and medicaid? You only get about 50% or less of what you bill.......
we pay for the rest through co-pays and deductibles.
Health care totally sucks!

Edit:
OK maybe not through Medicare and Medicaid. But definitely through private insurance.

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