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Old 08-28-2015, 05:20 AM
 
1,127 posts, read 1,317,776 times
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I know Medicare pays a lot less than private insurance for care.
And I wonder if I get short-shrift by doctors for this reason.
Or maybe that is just the nature of medicine today.

two examples:
I went to a doctor a couple of months ago, my friend had raved about him - how he listens, and gives a lot of time, etc.
So - 45 minutes in to the visit, I was asking a question, and he told me I was taking too much of his time!

when I got home, before I threw out all the literature I had received from him, I read the part where he tells new patients how much time he takes, blah blah, how an hour or more is not unusual for first visit, ...

and yesterday I went to an eye doctor, who had also been recommended by someone.
She gave me a cursory eye exam, told me I didn't need new glasses, did not not say why then I cannot see street signs, and why my eyes hurt when I'm online.

I want to get another doctor's opinion, but I don't know if Medicare will pay for me to get another eye exam. I will call them and explain the circumstances. In my opinion, Medicare should not pay the first doctor - but I don't know what position Medicare has on that.

I have a friend on Medicare and she swears that we older people get the shaft from medical people bec. they do not get paid well for caring for us.
I am starting to think she is right.
wonder what others think.
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Old 08-28-2015, 09:14 AM
 
Location: home state of Myrtle Beach!
6,446 posts, read 20,418,384 times
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I have been wondering about this too. I begged my husband to find another doctor that would help him more but he was happy with the one he'd been going to for over 10 years. Only problem is that he was diagnosed with terminal kidney cancer and even though he'd been complaining of symptoms, this doctor missed diagnosing him until it was too late to save his life. He died 20 days after diagnosis. When he first started seeing this doctor we had excellent insurance at first, but the last 3-4 years, he was disabled and on Medicare. Not sure if I should consider legal action or not.
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Old 08-28-2015, 12:02 PM
 
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myrc60,
so sorry for your loss.
esp. since it sounds like your husband could have lived longer with better care.

I don't know about legal action - I think it is pretty hard to sue a doctor...
but I wish you the best.
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Old 08-28-2015, 12:40 PM
 
Location: Wisconsin
23,625 posts, read 50,554,646 times
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Quote:
Originally Posted by ellenrr View Post
and yesterday I went to an eye doctor, who had also been recommended by someone.
She gave me a cursory eye exam, told me I didn't need new glasses, did not not say why then I cannot see street signs, and why my eyes hurt when I'm online.

I want to get another doctor's opinion, but I don't know if Medicare will pay for me to get another eye exam. I will call them and explain the circumstances. In my opinion, Medicare should not pay the first doctor - but I don't know what position Medicare has on that.

I have a friend on Medicare and she swears that we older people get the shaft from medical people bec. they do not get paid well for caring for us.
I am starting to think she is right.
wonder what others think.
A lot depends on where you are located and the providers you choose. In my city, I am two miles from the Medical College and its affiliated hospital. There are a raft of top-flight specialists one can be referred to at this facility if the PCP has any questions. The PCPs at this facility love their affiliation with this health system because it is a one-stop shop for the best and the brightest.

If your eyes are still bothering you, go to a better doctor, and fight with Medicare later. Fwiw, the clarity of my eyesight varies a lot - depending on what I've eaten, time of day, how tired I am. Eyes hurting online is a common problem. You can get screens for your laptop or PC monitor to cut down on the glare, change brightness, change background color of screen itself. I have taken an eye supplement for decades - can't live without 'em. Reduces light sensitivity, improves focus and night vision. You should consider that.

As far as short shrift, 45 minutes is quite a long time to be face-to-face with a doctor. Your Medicare status has less to do with this 'short' appointment than the time factor, itself, and the doctor running behind - thus keeping other patients waiting.

Back in the day, I had a relative who always booked 'double' appointments because she had so much to discuss. Since you are on Medicare, the docs get x for the appointment. If they want more money, they need to be submitting additional codes to Medicare for every issue discussed. I think that option is available to them.

Last edited by Ariadne22; 08-28-2015 at 12:50 PM..
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Old 08-29-2015, 06:18 AM
 
1,127 posts, read 1,317,776 times
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What is PCP?

What eye supplement do you take?

I take one called "Senior Vision", it containers Lutein.
I take it bec. it gets rid of those floaters.

If I don't take it the floaters come back.
and it seems to help a little with night vision.
I'm not sure. My night vision is very bad.

the eye doctor that I mentioned also said - when I told her about the supplement and the floaters, she said, "That's weird".
?
I don't know why it's 'weird', that's what they are supposed to do.
She also said in the eye exam she could see my floaters.

Quote:
Originally Posted by Ariadne22 View Post
A lot depends on where you are located and the providers you choose. In my city, I am two miles from the Medical College and its affiliated hospital. There are a raft of top-flight specialists one can be referred to at this facility if the PCP has any questions. The PCPs at this facility love their affiliation with this health system because it is a one-stop shop for the best and the brightest.

If your eyes are still bothering you, go to a better doctor, and fight with Medicare later. Fwiw, the clarity of my eyesight varies a lot - depending on what I've eaten, time of day, how tired I am. Eyes hurting online is a common problem. You can get screens for your laptop or PC monitor to cut down on the glare, change brightness, change background color of screen itself. I have taken an eye supplement for decades - can't live without 'em. Reduces light sensitivity, improves focus and night vision. You should consider that.

As far as short shrift, 45 minutes is quite a long time to be face-to-face with a doctor. Your Medicare status has less to do with this 'short' appointment than the time factor, itself, and the doctor running behind - thus keeping other patients waiting.

Back in the day, I had a relative who always booked 'double' appointments because she had so much to discuss. Since you are on Medicare, the docs get x for the appointment. If they want more money, they need to be submitting additional codes to Medicare for every issue discussed. I think that option is available to them.
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Old 08-29-2015, 11:30 AM
 
1,003 posts, read 1,602,816 times
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The reimbursement rate for Medicare patients is very low. Some doctors know how to improve this, some don't. Teh doctor is only going to get paid by Medicare, nothing from your supplement.

Seriously, getting more than a 15 minute appointment with less than 10 minutes with the doctor is going way above and beyond. Also, you have no idea how the office day is going. A previous patient could have been 90 minutes and now the doctor is way behind. If his office day was supposed to end at 5, now he is looking at 6 and then rounding the hospital might get him home at 8.

To tell you that you are taking too much time is not a nice way to approach a patient. However, some doctors have the bedside manner of a snail. If you want to get the most from your visits to any doctor, be sure you go in with a written list of major complaints to be addressed. Pull it out and refer to it so the doctor can see you have an agenda planned, not just wandering around conversing about every little ache. Prioritize your list with the most pressing complaint first. You may need more than one visit to get all of your concerns covered. Be patient. Also, something that eats up a ton of time in offices is figuring out what meds you are on and at what dose. Bring all of your presscriptions (in the original bottles) to your first visit. Doctors need to know what the label says, not what you say. Many people take their meds far differently than how they are prescribed and it makes a difference.

There are many new changes coming to doctors' offices that are starting right now that will impact your visit. You may feel that the same questions are asked at every visit to every provider. Doctors are going to be required to document certain information to get the highest reimbusement rate, which is already low. These are referred to PQRS and Meaningful Use if you want to do an internet search.

Given what they HAVE to ask and what you WANT to talk about is going to leave very little time to get to the heart of the reason you are there.
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Old 08-29-2015, 12:48 PM
 
Location: Chesapeake Bay
6,047 posts, read 4,245,460 times
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Quote:
Originally Posted by utsci View Post
The reimbursement rate for Medicare patients is very low. Some doctors know how to improve this, some don't. Teh doctor is only going to get paid by Medicare, nothing from your supplement.
Why isn't the doctor going to be paid by the supplemental insurance?
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Old 08-29-2015, 01:47 PM
 
1,584 posts, read 2,171,255 times
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Quote:
Originally Posted by ellenrr View Post
I know Medicare pays a lot less than private insurance for care.
And I wonder if I get short-shrift by doctors for this reason.
Or maybe that is just the nature of medicine today.

two examples:
I went to a doctor a couple of months ago, my friend had raved about him - how he listens, and gives a lot of time, etc.
So - 45 minutes in to the visit.......
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Old 08-29-2015, 01:48 PM
 
Location: Wisconsin
23,625 posts, read 50,554,646 times
Reputation: 18430
Quote:
Originally Posted by ellenrr View Post
What is PCP?

What eye supplement do you take?

the eye doctor that I mentioned also said - when I told her about the supplement and the floaters, she said, "That's weird".
?
I don't know why it's 'weird', that's what they are supposed to do.
PCP = Primary Care Physician

Supplement - Vision Essentials (Forward Nutrition/DrWhitaker - 1-800-722-8008) - six month supply $150 or thereabouts. Can't live without 'em. This was the only eye supplement (and I have tried a ton) that works for me. Most docs have no training in nutrition and many don't believe in supplements.

Quote:
Originally Posted by Weichert View Post
Why isn't the doctor going to be paid by the supplemental insurance?
Indeed. Of course, supplement picks up its share of any Medicare-approved charge. Maybe she means doc isn't paid an additional fee.
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Old 08-29-2015, 07:32 PM
 
1,003 posts, read 1,602,816 times
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Sorry, I should have stated it differently. Medicare has a set fee that they pay doctors depending on the codes that are billed. Medicare pays the doctor 80% of that stated allowable fee and the patient is responsible for the remaining 20%, That's where your supplement comes in. The supplement pays the other 20% (sometimes) of the bill or close to it. So between Medicare, the supplement, and sometimes the patient the doctor collect the whole 100% of the Medicare allowable fee.

And see it from the doctor's business office perspective...you are seen and they bill Medicare. Medicare pays 80%. The business office then bills your supplement. They pay their portion. Then if there is anything left unpaid the business office bills the patient.

A lot of work for a very small return. It doesn't excuse treating patients differently depending on their insurance. But just try to think of all the work that goes into the business of medicine after the clinical work is done.
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