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Originally Posted by Robyn55
I guess - judging from your name here - that you are on the "dentist" side of this - not the "doctor" side - right? I've had experiences with both (although only with my late FIL on the doctor side - he had angiosarcoma - a horrible aggressive cancer - on his head). The doctor my FIL saw at Mayo took Medicare. Our family oral surgeon dropped out of Medicare about 5 years ago (it was a small part of his one man practice and he couldn't stand dealing with Medicare either). And I doubt he's unique in this neck of the woods. Perhaps it's an issue of being in a big outfit where you have a large billing department versus being in a small outfit?
FWIW - I can understand your billing/coding frustrations. We as consumers/patients have them too. For example - my husband had endocarditis years ago - has a small hole in his heart valve - and needs a yearly echo to make sure he's ok. Medicare won't pay for a yearly echo for everyone. And even Mayo has trouble every year getting the billing code right for his echo.
Of course - ICD-10 just makes it harder for everyone:
Forbes Welcome
Medicare or no Medicare. Robyn |
Our specialty is on both the dental and medical side of things. Some days of the week I remove wisdom teeth and place dental implants. Other days of the week I cut off jaws, tongues, and faces and reconstruct them, although I don't really get paid for it since insurance reimbursement for those procedures barely covers the cost of paying my staff. The most common procedure for me is to remove a jaw, remove lymph nodes from the neck, tracheostomy, harvest bone with its blood vessels from the leg, re-attach the blood vessels to the neck vessels under a microscope using sutures slightly smaller than a human hair, then shape the bone and rebuild the jaw, and use skin from the leg to rebuild he tongue/cheek, etc. This takes me about 8-10 hours. Medicare pays me the same as I get for taking out 2 sets of wisdom teeth which I can do in less than an hour. Private insurance doesn't pay much more. And the difference in liability, training, time spent taking care of the patient after surgery (for free) is immensely different.
This is the reason most surgeons in my specialty don't bother treating those patients. I am one of 3 surgeons in the country able to do a certain type of total jaw reconstruction in 1 surgery (instead of 4+ operations spanning over 18 months like everyone else does it) but insurance/Medicare will not pay for it. So dropping Medicare doesn't keep me from doing that surgery any less than it did before.
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. People often don't realize what dentists can do and do do. I have a cousin who's kind of a big deal oral surgeon in the NY metro area. He makes a fair amount of money off some patents and things like implants. But he still goes to central America every year with other oral surgeons to do cleft palate surgery on kids. My prosthodontist here (I'm kind of a dental basket case) does amazing reconstructions when people are screwed up by things like terrible accidents and cancers. He pays the bills with cosmetic stuff - and basically hopes to break even/not lose a lot of money on the more challenging things.
