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Let's not forget that your medical education was subsidized by government grants to universities. You didn't pay the full cost of your education. Tax dollars helped to subsidize it, including tax dollars that those people who are now on Medicare that you are "kicking ... to the curb in ... January 2016".
I'm not sure what you're saying. Those subsidies are less than any other country as evidence by the fact that doctors pay enormous amounts for their education while in other countries it is paid for completely by the government. And if Medicare is not paying me enough to pay my employees and office rent then it's simple math regardless. I'm not kicking patients to the curb, I am kicking the government program Medicare to the curb. The patients are still welcome to see me just like everyone else. The entitlement mentality is the reason people think they "cannot" pay for a $100 office visit while many women pay more than that for their haircuts.
I have knowledge of the current procedures as a Medicare provider. Although I am kicking Medicare to the curb in my practice on January 1st, 2016.
I wish it was as simple as just submitting a code. We have to submit the code with "correct" modifiers, and with a diagnosis that will link to the code. But they WILL NOT tell us the "correct" way to do it. For example, I had a claim denied yesterday for a 38724 (modified radical neck dissection) that I submitted with a -59 modifier indicating a separate procedure from the 41130 (hemi-glossectomy) I also did. I have learned that without the -59 modifier Medicare will deny it and tell me that I should have used 41135 (glossectomy with radical neck dissection) because it includes the neck dissection. But they are incorrect about that because 41135 includes a radical neck dissection (38720), but not a modified radical neck dissection. For the first time in years, they found a new way to deny it. They sent back a denial letter stating the 38724 code requires an "anatomical modifier" even though they have never required it before. And there is no database that lists which of the 60+ modifiers are required in any situation. So now I have to pay my staff again to re-submit the claim again with a 38724-59,LT series of modifiers to see if that will work. We called them to ask and, as expected, they said "we cannot tell you how to code." I hope the one I submitted is the one they are looking for. It took me 2 months to find out the first time and now it will take another 2 months to see if I got it right. Who else here likes to work and not get paid for 4 months?
I have learned that the general public really thinks we just submit a bill to the insurance company that says "broken arm, fixed it" and we get paid. Every dollar is a fight. Remember...insurance companies are not in the business of paying claims, they are in the business of NOT paying claims.
It can all be a frustrating mess, that's for sure. And yes, not everything is as simple as a broken arm.
So now I have to pay my staff again to re-submit the claim again with a 38724-59,LT series of modifiers to see if that will work. We called them to ask and, as expected, they said "we cannot tell you how to code." I hope the one I submitted is the one they are looking for. It took me 2 months to find out the first time and now it will take another 2 months to see if I got it right. Who else here likes to work and not get paid for 4 months?
My husband left an Ortho practice over 3 years ago and he still receives quarterly checks of about $500-750 from them because they are graciously still doing his Accounts Receivable, which is really above and beyond. The P&L doesn't reflect who the payers are, but he guesses it's Workers Comp, "bad" insurers, and self pay patients who were sent to collections.
Just recently getting paid for a service provided several years ago...
Try educating yourself. This was in 2002. I am sure it has increased in the last 13 years. Perhaps Medicare should stop funding education since many doctors drop Medicare patients anyway.
Graduate medical education (GME) is a core mission for over 1,500 hospitals and all 125 medical schools in the United States, educating doctors who set world-renowned standards for medical excellence.1–3 Currently, Medicare supports teaching hospitals with $7.8 billion per year for their GME, while Medicaid funds over $2 billion and the Department of Defense, the Veterans Administration, and private payers also pay for portions of resident physician education.4 Despite this substantial support, teaching hospitals are struggling financially and their educational mission is under stress. The reasons are multifactorial, and include rapid changes in medical technology, decreased reimbursements for clinical services, increasing uncompensated care, increasing wage costs, and reductions in federal GME payments.3,5
Try educating yourself. This was in 2002. I am sure it has increased in the last 13 years. Perhaps Medicare should stop funding education since many doctors drop Medicare patients anyway.
So interestingly, when I was a resident 10 years ago, the program was given ~$100k per resident per year to train them. $35k of that was our "salary" (or stipend or whatever you want to call it - what they gave us to live on). I'm sure the rest went to paying our attendings, running the program, some materials, etc.
So, even with the 80 hours a week rule in effect (which it wasn't until midway through my residency and it was a big joke anyway bc you basically just had to lie or get in trouble), let's do some math.
But let's assume 80 hours. So for $100k, you get someone working and providing medical care for around $24 an hour for 3 to 5 years (and by the 3rd year, many function as well as an attending), of which they only receive about $8 so they can pay rent for the apartment they never sleep in.
I'm not sure what you're saying. Those subsidies are less than any other country as evidence by the fact that doctors pay enormous amounts for their education while in other countries it is paid for completely by the government. And if Medicare is not paying me enough to pay my employees and office rent then it's simple math regardless. I'm not kicking patients to the curb, I am kicking the government program Medicare to the curb. The patients are still welcome to see me just like everyone else. The entitlement mentality is the reason people think they "cannot" pay for a $100 office visit while many women pay more than that for their haircuts.
Or pay for their health insurance premiums...."afford" is relative....
So interestingly, when I was a resident 10 years ago, the program was given ~$100k per resident per year to train them. $35k of that was our "salary" (or stipend or whatever you want to call it - what they gave us to live on). I'm sure the rest went to paying our attendings, running the program, some materials, etc.
So, even with the 80 hours a week rule in effect (which it wasn't until midway through my residency and it was a big joke anyway bc you basically just had to lie or get in trouble), let's do some math.
But let's assume 80 hours. So for $100k, you get someone working and providing medical care for around $24 an hour for 3 to 5 years (and by the 3rd year, many function as well as an attending), of which they only receive about $8 so they can pay rent for the apartment they never sleep in.
I don't consider that $100k a gift.
Considering physicians also give up decent earnings for 7 - 10 years AFTER completing college, I wholeheartedly agree.
I didn't say it was a gift, but that it was subsidized.
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