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Old 06-03-2019, 08:40 PM
 
Location: Austin
12,209 posts, read 6,945,397 times
Reputation: 13448

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Quote:
Originally Posted by toofache32 View Post
$1200? I need to raise my fees. Both you and your doctor are right in some areas, and you are both wrong in some areas. I am the same type of doctor and do these biopsies several times a week.



As for the fees, an oral biopsy in my office is below half that price, unless you need IV sedation or if it is in bone which is more involved. What type of lesion was this? Was it a fibroma? Is he in-network with your insurance? I wonder what insurance pays that much for a biopsy. OR....is this the "superbill" fee while you simply haven't gotten an EOB yet to determine how much you will ultimately owe?



I like to call patients for biopsy results if I am highly confident it is benign. It saves me chair time from a second visit, increases patient satisfaction, and is more efficient since I can call the patient the same day the results are available.

If there is a reasonable chance it could be malignant, then the patient needs to come back for the results because this is a face to face conversation which is a long conversation since the patient always has a million questions after they hear they have cancer, and requires more time than a phone call allows. A phone call is to give results, PERIOD.

Do you really want to know you have cancer by phone?

"Hey Mr. Jones your biopsy shows you have cancer."

"Well what is my next step?? Is it treatable?? Is it fast growing?? Will I need radiation? Has it spread to other parts of my body??"
"We'll answer those questions when you come in next week because this is just a phone call to give you the results."



I don't charge the patient for the second visit, although by insurance rules, you can. If this doctor is in-network with your insurance, then the insurance makes the rules. Usually insurance doctors charge for the follow up visits because the initial visits are paid so poorly and don't cover a 2nd visit. But I still wonder what insurance this is.


Lastly, I'm SICK of patients saying they only had a 3 minute visit. Stop exaggerating. Would you feel better if he took 30 minutes? Physiology does not allow local anesthesia to be administered and a procedure performed this quickly, in addition to the examination, discussion of recommendations (biopsy) and discussion of what this might be. When I leave the patient room, they must think I am done. They don't realize I spend about the same amount of time filling out pathology paperwork, documenting the visit, and coding.
Serious question: how long did the doctor spend on your case when he was NOT in the room??
you didn't hear a single word I said.
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Old 06-03-2019, 09:38 PM
 
1,500 posts, read 1,638,381 times
Reputation: 2248
Quote:
Originally Posted by texan2yankee View Post
you didn't hear a single word I said.

Not helpful. Fill me in here. I would like to help.
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Old 06-03-2019, 09:43 PM
 
1,500 posts, read 1,638,381 times
Reputation: 2248
Quote:
Originally Posted by Mikala43 View Post
Sign up for online access to your lab results, or tell them to mail a copy to you directly.

I did the mail until online became available, and that way I can look at my lab results the same day. I would NOT show up just for them to say I am A-ok.

Online if available. Online access is available with large hospital-based EMRs such as EPIC which cost several million dollars. Not available for private practice. I don't know which setting this person was in. My EMR personally cost me $70,000 and does not include online access.
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Old 06-04-2019, 12:45 AM
 
Location: Middle of the ocean
31,628 posts, read 19,955,234 times
Reputation: 45699
We have two large private clinical labs here, they both offer free access.
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Old 06-04-2019, 08:58 AM
 
Location: too far from the sea
19,836 posts, read 18,845,295 times
Reputation: 33741
Due to a reported post, let's try to be more sensitive to others' complaints. At least listen to what they say, if no more. Thanks.
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Old 06-04-2019, 10:22 AM
 
Location: SW Florida
9,745 posts, read 7,030,085 times
Reputation: 14234
Quote:
Originally Posted by toofache32 View Post
Online if available. Online access is available with large hospital-based EMRs such as EPIC which cost several million dollars. Not available for private practice. I don't know which setting this person was in. My EMR personally cost me $70,000 and does not include online access.
The docs I go to have EMRs that include a patient portal that allows the patient access to at least some of his/her medical records. The system I see they commonly use is Athena. I know it'd have to be a pretty penny to set up and maintain, but the providers I go to are part of a very large group practice, or are managed by a large practice management organization, and are tied in with the local hospitals as I understand it. That'd make the expenses of of an EHR with all its buzzers and whistles a bit more affordable to each practice, I'd think. It'd be a whole lot harder for a small independent practice to afford an EHR like that.

But even with the patient portal, not all patient records are available online. Basically what I see when I look at mine are scheduled visits, diagnoses, physician summary assessments for each visit, lists of procedures scheduled or done, vital signs and lab results. The record list and show date for procedures, but show no online results for thing such as x-rays, bone scans, colonoscopies and so on, and no pathology reports. Surgical reports don't show in the portal either.

So I'm thinking, if you're a dental surgeon, the records of your work on patients would be more in line with the descriptions and results of procedures, surgeries and pathology reports-ie, not available for viewing online on a patient portal. So seems to me an electronic system for patient records for in-office use, with records printed, faxed, or documents emailed to other providers as needed would suffice. Come to think of it, I believe that's what our dentist does.

My uneducated take on it, anyway.
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Old 06-21-2019, 10:41 AM
 
Location: PA
2,109 posts, read 1,848,559 times
Reputation: 5408
Currently I am in the process of looking for a new PCP. I of course don't know all the challenges and regulations that doctors face, and I try my best to be a good patient, but, like in every profession, there are varying degrees of competence.

I am having gastrointestinal issues that are exacerbated by stress. I was diagnosed with IBS six years ago. I didn't start having problems with doctors until the one I was seeing stopped practicing and I had to find a new one. This one, the last three visits, has straight up interrupted me or cut me off when I was talking, spent visits talking about tests and shots completely unrelated to the reason for the visit, and like others have said, I felt like the care I received was more about following some sort of procedure rather than treating a person. That's a source of stress in and of itself.
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