You are correct it can be a nightmare to keep track of all the claims, rules etc. It's what I do for part of the day.
Why do Dr's in Ohio like Medicare because they pay the Dr well? They are one of the highest paying plans, and you have a year to submit claims where with United Health you have 90 days to collect your money.
Here in Ohio Medicare patients have no copay, most that I talk to love their insurance. Most here have a secondary I would say 97% do, either AARP, Medicaid, BCBS etc.
Knowing what your insurance covers is important.
I do not understand however how the office staff could not know what you were billed for, it's all coding which is universal throughout the US and. 367.1 means you are near sighted. 365.10 means gluacoma no matter what state you are in.
And yes we do have to wait for the insurance company to process the EOB, on it is the following info. Your copay, your deductable, the allowed amount, the amount to be written off, why it might have been denied and YES you should also recieve a copy from the insurance company with the same info. If you have questions, pick up the phone and call the insurance, you pay for it and it is there to protect you.
It is not the Dr's responisbiltiy to know your deductable or your benefits, it is yours. There are thousands of companys out there and each is a bit different.
However things are now changing and we will soon be able to look on-line at your info before you walk into the office. If you have not met your deductable and the office visit is $200.00 you will be expected to pay that up front or to make arrangements for a payment plan. Dr's have a hard time collecting from many people and this will change that. You cannot go into a grocery store or gas station and get the products and say bill me, soon you won't be able to do that at the Dr as well.
I hope Obama gives all Americans decent health care no matter how you slice it we all deserve that. I also hope that we take better care of ourselves if possible so that we may avoid or slow down heart disease, diabetes, high blood pressure and many other illness that come with a not so healthy lifestyle.
Quote Originally Posted by Edwina's Secretary View Post
It makes you wonder, SAS, who pays rack rate or whatever the non-discounted rate is called. The uninsured? Those with the old style indemnity plans?

I looked at a new product - high deductible - sounds like Jo has a version of this. Like the concept but couldn't get comfortable with it...will people with this type of plan pay rack rate?

And imagine a doctor's office trying to keep track of all these different plans ahd how they work and what they pay!

Must be a nightmare.