Employed by Insurance Companies
Receiving lots of denials from insurance companies. Getting worst each year.
Genicular nerve blocks as well as other procedures determined to be experimental in my area as per insurance company based on their 5 minute “UpToDate search”
Even performing an epidural steroid injection for a nerve impingement secondary to epidural scarring following a laminectomy. They will approve a repeat surgery though…
Are others having difficulty as well? They are cutting reimbursement left and right...
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Source: Student Doctor Network - May 2, 2022 Category: Universities & Medical Training Authors: BloodySurgeon Tags: Pain Medicine Source Type: forums
We Only Pay For 'X' Amount of Fractions. But You Want More...
Let's say Evicore through prior auth and peer to peer will only pay for 28 fractions. However, you don't want to do that for your patient and instead treat with 40 fractions. You bill the insurance company for 28 fractions; however, of course your own in house medical records would show 40 treatments. The example is a prostate case. Is doing more treatments, but not billing for them, against any known guidelines or laws, regarding any payor? Examples would be nice. This seems to be a big...
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Source: Student Doctor Network - April 26, 2022 Category: Universities & Medical Training Authors: TheWallnerus Tags: Radiation Oncology Source Type: forums
Health Insurance for Private Groups
For those of you that are in private/independent anesthesia groups - what do you do for health insurance? My group will be needing new health insurance coverage in the next year and I’m preparing to start searching. What’s the best way to approach this - hire a broker? Just call each insurer? Any tips on how to get a better deal? (Source: Student Doctor Network)
Source: Student Doctor Network - April 14, 2022 Category: Universities & Medical Training Authors: Airlife91 Tags: Anesthesiology Source Type: forums
What do you guys think? is ortho really THAT BAD in terms of EBM? will we see less surgeries in the future?
Summary of the video:
The first study looked at the top 30 most commonly performed procedures in ortho found 3 low risk of bias RCTS ONLY
The second was for MSK pain procedures - no LRB RCTs
So most of orthopedic procedures taken as standard nowadays have a very weak evidence base, does that mean that we will see far less ortho procedures in the future with far more stringent indications? especially if insurance companies catch up and stop reimbursing procedures that...
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Source: Student Doctor Network - March 26, 2022 Category: Universities & Medical Training Authors: Doc mu Tags: Orthopaedic Surgery Source Type: forums
Prospective PT students
Are you sure you wish to sign up for a field with terrible wages and continuously decreasing reimbursement?
Disrespected by other medical professionals and insurance companies?
Honestly will be ahead financially in life if you start working for McDonald’s right out of college. (Source: Student Doctor Network)
Source: Student Doctor Network - March 15, 2022 Category: Universities & Medical Training Authors: GiovanniGeorgio Tags: Pre-Physical Therapy Source Type: forums
Which job opportunity would you take if offered ?
So I’ve had two job interviews since I started searching in the last 1.5 months . I’ve been working retail for 9 years . If selected , which of these two would you choose ? CVS specialty in an office like setting about 15-20 minutes commute Monday to Friday with with their an 8-4:30 shift, 10 to 6, or 9 to 5 plus no weekends or holidays and pay between $55-58 per hour OR remote staff pharmacist position from home with an insurance company ? The insurance company pays $52 per hour and...
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Source: Student Doctor Network - March 14, 2022 Category: Universities & Medical Training Authors: DoctorRx1986 Tags: Pharmacy Source Type: forums
The future of dentistry
Just saw this post from a while back on didn't see any responses to it. As someone new to the field this was a bit intimidating so I'd like to hear your thoughts on this.
"I'm a dentist that graduated 18 years ago. Sounds like you're a smart kid and I'm sure what ever path you choose you will be very successful. Dental school right now it's a rip off. Paying $500K for a dental education is financial suicide. Dental insurance companies are killing the dental industry. Dental insurance been...
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Source: Student Doctor Network - March 2, 2022 Category: Universities & Medical Training Authors: ongerie Tags: Pre-Dental Source Type: forums
QPA and the No Surprises Act
I am just wondering how other anesthesiologists are feeling about the QPA being, basically, the sole deciding factor for out of network reimbursement. Overtime this QPA, which is supposed to be the 50% median in network rate, will drop as there is 0 incentive for the insurers to renew your contract at high rates because if they don't, well you can get a MAX reimbursement of the 50% median in network rate. As contracts get cancelled or lower that QPA goes lower and lower.
Secondly, there...
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Source: Student Doctor Network - February 8, 2022 Category: Universities & Medical Training Authors: Luvssjeter Tags: Anesthesiology Source Type: forums
Ab 1400
Calcare is a M4A style single payor universal healthcare. Supported by 65% of Californians. We have a large proportion of indigent and uninsured patients. Would be nice if everyone is covered. Private insurance companies will oppose it.
https://cdn.ymaws.com/www.naswca.org/resource/resmgr/files/2021lld/AB-1400-fact-sheet.pdf (Source: Student Doctor Network)
Source: Student Doctor Network - February 1, 2022 Category: Universities & Medical Training Authors: nimbus Tags: Anesthesiology Source Type: forums
Cataract Surgery Anesthesia Models
We are considering an anesthesia group who's model is out-of-network for all insurances for an eye surgery center. I guess there are a few insurance companies that pay beaucoup bucks for out of network charges. I personally find this a little distasteful and am worried patients will be hit with a surprise charge and this will blow back on us. That being said, I've been told by some of our anesthetists they've been proposed medicaid rates by some insurance carriers and that's not right...
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Source: Student Doctor Network - January 19, 2022 Category: Universities & Medical Training Authors: dantt Tags: Anesthesiology Source Type: forums
Insurance company profit: makes one want to vomit, no?
UnitedHealth calls for revenue between $317 billion and $320 billion for 2022
UnitedHealth Group Inc. undefined late Monday said it expects 2021 revenue of around $287 billion, and per-share adjusted earnings between $18.75 and $18.90...
www.marketwatch.com
TTM (Trailing Twelve Months) Revenue = ~ 280B
TTM Operating Income = ~22B
22 BILLION profit.
Imagine all the extra care they can pay for if they had...say...just 2B in profit. I wouldn't mind if they had 2B in profit and paid out 278B in health care (Source: Student Doctor Network)
Source: Student Doctor Network - December 20, 2021 Category: Universities & Medical Training Authors: thegenius Tags: Emergency Medicine Source Type: forums
Professional Liability Insurance
Hello,
I have decided to change liability insurance companies and have received a quote for Hartford from an insurance broker.
Does anyone have any information to share about Hartford? Which insurance companies do you recommend and which ones should I avoid?
Thank you. (Source: Student Doctor Network)
Source: Student Doctor Network - December 9, 2021 Category: Universities & Medical Training Authors: the2thdoctor Tags: Dental Residents and Practicing Dentists Source Type: forums
Recent grad going through dental credentialing
As the title implies, I am considering applying for credentialing with some insurance companies. As per my reading, you can do it yourself or have a service do it for you. I am wondering if there is comprehensive guide/course to assist? Has anyone tried ADA's CAQH service for dental credentialing?
Thanks! (Source: Student Doctor Network)
Source: Student Doctor Network - December 8, 2021 Category: Universities & Medical Training Authors: DrTMD Tags: Dental Residents and Practicing Dentists Source Type: forums
Peer to peer
What do you all do when you have to talk with clueless physicians from the insurance company who are not in your specialty? recently talked to a clueless doctor and i asked her her name, contact info and specialty. She got pissy and told me "we are done here" and I said well clearly this is the wrong decision or something like that and I want to know i'm talking to someone in my same specialty. She called me a few minutes later to tell me she reconsidered her decision and she was approving...
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Source: Student Doctor Network - December 4, 2021 Category: Universities & Medical Training Authors: Iamnew2 Tags: PM&R Source Type: forums
Is fellowship required for spine procedures?
Is it possible to perform spinal procedures like ESIs or RFAs without doing a spine fellowship? It is my understanding that insurance companies want evidence you know what you are doing such as a case log before they will pay you. If I was able to perform enough of these procedures in residency would that suffice? Thanks for any responses. I am trying to learn more about billing and the business side of medicine. (Source: Student Doctor Network)
Source: Student Doctor Network - December 3, 2021 Category: Universities & Medical Training Authors: MavFab Tags: PM&R Source Type: forums
