Insurance companies are shameless
Joined large private practice group out of fellowship, application submitted in June to be credentialed for company. Told 90-120 day processing.
Followed up weekly, told “should be good by mid-November, all is complete in August”.
Last week told “missing education verification”.
This week told “application is lost, resubmit and wait 90-120 days”
This happened to one of our surgeons too. CEO got on phone with insurer and lost their mind, threatened to essentially drop the entire company...
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Source: Student Doctor Network - November 8, 2022 Category: Universities & Medical Training Authors: GlowInTheDark Tags: Pain Medicine Source Type: forums
Tail Insurance
After 6.5 years at my current gig, I am making a switch to another group. I currently have a claims-made policy with The Doctors Company and need to purchase tail. I have a quote ($21k) from TDC but I've been told I can shop around for better prices from other insurance companies. I've only had TDC, so I was hoping members here could chime in with the names of malpractice insurance companies I can contact?
Thank you! (Source: Student Doctor Network)
Source: Student Doctor Network - November 7, 2022 Category: Universities & Medical Training Authors: Folken Tags: Anesthesiology Source Type: forums
UHC United Healthcare requiring NDA before signing on as provider, anybody familiar with this!
Hi has anyone when credentialling as a provider with an insurance company been asked to sign a blanket NDA to cover "rate fees" and "contractual terms" so as to become enrolled in the provider network? This seems a violation of some law, Stark Law or pushing a physician to practice medicine in the payer's best interest or practicing medicine as business vs. clinical best interest.
I would like to post the NDA for your review but some blip in the footer says I can't.
HIPAA pretty much covers...
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Source: Student Doctor Network - October 29, 2022 Category: Universities & Medical Training Authors: SJellyModo Tags: Anesthesiology Source Type: forums
FDA approves 'SKOUT' - a new AI device to detect colon polyps
https://www.cancertherapyadvisor.com/home/cancer-topics/gastrointestinal-cancers/fda-clears-skout-to-detect-colorectal-polyps-in-real-time-during-colonoscopy/
Interesting article that leads to more questions: Does FDA approval mean gastroenterologists can bill more for using the device vs standard colonoscopy? If so, will insurance companies reimburse for it?
And on the path end, does this mean receiving more or less colon biopsies if this becomes widely adopted? I could see...
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Source: Student Doctor Network - October 28, 2022 Category: Universities & Medical Training Authors: coroner Tags: Pathology Source Type: forums
How does this inpatient job sound?
Community hospital. Set your own cap, do your own Billings. The hospital is majority Tricare with about 35% private insurers. I've been told my average billings will work out to 85ish an encounter, which seems low. So a patient cap of 15 should generate about 1300 dollars a day. Again seems very low but maybe this is because of Tricare making up a large part of their mix? Also, this is in Socal mind you.
The other thing which seems odd, but maybe it's normal, is the fact you're responsible...
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Source: Student Doctor Network - October 21, 2022 Category: Universities & Medical Training Authors: surfguy84 Tags: Psychiatry Source Type: forums
SCS for low back pain
What diagnosis codes (for insurance/ Medicare approval) do you use for the 80+ year old, non surgical patient with severe arthritis, severe multilevel stenosis, cauda equines impingement, never had surgery/not offered surgery because of age but wants to try SCS? I think it’s perfectly reasonable to offer this to patients but running into insurance companies who don’t think so because “patient never had back surgery” or doesn’t have “crps”? (Source: Student Doctor Network)
Source: Student Doctor Network - October 11, 2022 Category: Universities & Medical Training Authors: painfree23 Tags: Pain Medicine Source Type: forums
Disposable nasopharyngoscopes
Our clinic is looking into disposable options for nasopharyngoscopes for head/neck patients. Is there a brand that you like? I heard that the scopes can be charged to the patient's insurance company. What codes do you use when billing for the scopes? Thanks! (Source: Student Doctor Network)
Source: Student Doctor Network - August 27, 2022 Category: Universities & Medical Training Authors: echod Tags: Radiation Oncology Source Type: forums
No Surpises Act in layman's terms?
Maybe it's because I don't do my own billing but I really could use some help here. Can I get help understanding how the No Surprises Act works in the world of Anesthesia?
Let's use a simple case report to analyze:
- Insured patient comes for appendectomy, receives surgery.
- Afterward it was found that surgeon, emergency physician, and facility are in-network, covered by their insurance company hypothetically named INSURANCECOMPANY
- Anesthesiologist is deemed out-of-network by...
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Source: Student Doctor Network - July 11, 2022 Category: Universities & Medical Training Authors: ethilo Tags: Anesthesiology Source Type: forums
malpractice insurance
Hey,
I was wondering if anyone has any input on malpractice insurance companies they'd recommend? I am a soon to be attending in psychiatry and there are so many companies I'm not sure where to start. I will only be working part time and practice in WI if that helps. I am not as much concerned about price. I am more concerned about ensuring there is good coverage and service should a patient ever file a claim against me (no one in mind of course, but you never know, I've still got my whole...
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Source: Student Doctor Network - July 10, 2022 Category: Universities & Medical Training Authors: randomdoc1 Tags: Psychiatry Source Type: forums
How much health insurers pay for almost everything is about to go public...
How much health insurers pay for almost everything is about to go public
New government rules are forcing insurers to post on websites what they pay for care or be fined, allowing consumers and employers to comparison shop for health services or negotiate better rates.
www.npr.org (Source: Student Doctor Network)
Source: Student Doctor Network - July 1, 2022 Category: Universities & Medical Training Authors: pastafan Tags: Pain Medicine Source Type: forums
Other SCOTUS news
Hopefully none of the fetuses they save become afflicted with ESRD. They’re a joke.
“The court rejected a claim from DaVita Inc. that low health insurance reimbursement rates violated federal law. (APN Photography via Shutterstock)
Tuesday’s opinion in Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc. laid out a roadmap for private insurers to shift the costs of end-stage...
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Source: Student Doctor Network - June 26, 2022 Category: Universities & Medical Training Authors: nimbus Tags: Anesthesiology Source Type: forums
ABPM International Podiatry
ABPM International
If I practice podiatry in the UK or Australia where the scope of practice is definitely limited what does getting ABPM certified do? Is it going to allow them to get surgical privileges? No. Will orthopedists in UK and Australia dropped to their knees and bow down to the Podiatrists that just hung their newly framed USA certification on their office wall? No.
Are insurance companies going reimburse providers in these countries any differently? No...
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Source: Student Doctor Network - June 23, 2022 Category: Universities & Medical Training Authors: CutsWithFury Tags: Podiatric Residents & Physicians Source Type: forums
Private Insurance Reimbursement Rates
Is it normal for some private insurers to pay substantially less than Medicare? I'm new to CPT billing and my current position pays me based on a percentage of CPT code billed. I know what the 2021 Medicare rates are for common psych CPT codes, but the information provided from the company is showing some of the private large insurers as contracted for substantially less, most below $60 total for a 99213 across companies, or around $100 for a new 99204. Is this normal reimbursement or am I...
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Source: Student Doctor Network - June 1, 2022 Category: Universities & Medical Training Authors: OriginalBlend Tags: Psychiatry Source Type: forums
Double Billing with One Provider
Is it an insurance malpractice or a professional malpractice to perform interventional pain procedures while giving nurse directed anesthesia at the same time (versed without another CRNA/AA/MD). The bill to the patient will be for both monitored anesthesia care sedation and for the pain procedure.
What if the patient is willing to pay cash?
I’m asking since I’ve seen this being practice in other locations and wondering if it was taboo because we work with insurance companies who set the...
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Source: Student Doctor Network - May 15, 2022 Category: Universities & Medical Training Authors: BloodySurgeon Tags: Anesthesiology Source Type: forums
Hospital looking to get 7.5-15% increase in payments
This is great. Increase in site of service fees of 7.5-15% if they get what they want guess where that cost will shift to? Doctors and patients is my guess.
Hospitals Look to Raise Treatment Costs as Nurses’ Salaries Increase — The Wall Street Journal
Health insurers and employers are pushing back against requests to increase hospital prices by as much as 15%
apple.news (Source: Student Doctor Network)
Source: Student Doctor Network - May 9, 2022 Category: Universities & Medical Training Authors: myrandom2003 Tags: Pain Medicine Source Type: forums
