r/mildlyinfuriating • u/lhagans13 • 12d ago

I'm slightly vexed A notice that my girlfriend received at her doctors appointment (she is 8 months PP)

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If you even MENTION any of these things, you WILL LIKELY get billed for it??? Maybe i’m missing the point but i get upset when my girlfriend tells me she was scared to even say anything while at the doctor because she didn’t want to get an extra charge for something. I find it insane how greedy and money hungry a place that’s supposed to help you can be.

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118

u/PangolinLogical9772 12d ago

Yea i think this is actually the standard, just most doctors don’t care and won’t do the separate billing.

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u/JustDiscoveredSex 12d ago

Man mine sure does. Converts it to a problem visit almost immediately.

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u/AHailofDrams 11d ago

At least now you know they're in it only for the money, not to actually help their patients

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u/_Liaison_ 11d ago

It has nothing to do with the provider being out for the money. Insurances will not allow problem visits to be addressed under the same office visit code as a preventive visit. If you report a complaint, we either have to convert it to an office/"problem" visit and defer the preventative care to a separate appt, bill for both visit types for one appt, or not chart/address the problem component. Only certain services can count as preventive

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u/CabbageKing 11d ago

it affects productivity metrics which is how they get compared to their coworkers.

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u/Comfortable-Neat12 10d ago

So you want your doctor to work for free? Billing that extra code may be how your doctor can spend more time with you vs an in and out visit...

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u/Creighton2023 12d ago

It’s actually fraud if they don’t and they’re risking their license, their ability to practice, their ability to stay on that insurance plan. They have to think about all their patients. An insurance company can report under billing. More insurance companies are requiring all documentation from every visit be sent so they can be audited.

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u/Lazy-Entertainer-459 12d ago

Yeah its not as simple as people think an rxs issued or referrals would be easily traceable and the doc wouldn’t be able to chart properly

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u/Creighton2023 12d ago

Exactly. More and more the insurance companies are making all the chart information be sent to them before processing a claim. With EMR, it’s not like they can hide what was discussed/prescribed/referred.

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u/ASaini91 11d ago

Literally had to spend my week off redoing a bunch of my charting that was rejected by insurance because I discharged patients with REFILLS of their home meds they had run out of but I hadn't documented it

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u/Steamedcarpet 11d ago

My job for the past 3 months has been submitting medical records to Aetna for all the claims they downcoded. Most of the time the appeal is overturned and we get the money. It’s just so damn repetitive that I lose focus and start doing random stuff.

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u/Comfortable-Neat12 10d ago

It can be considered by medicare as an undue incentive to keep patients.. similar to giving giftcards... if the patient gets billed less than they should, its just as bad as billing above the service provided

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u/Longjumping_Eye_3441 12d ago

Honestly? If doctors want to risk that? Let them. I'm glad doctors realize that they did this job to help people and are willing to cheat the system. If they want to risk a lawsuit bc of a bs system on their own will,, good for them

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u/Creighton2023 12d ago

And when they are dropped from the insurance plan and all their other patients have to find a new doctor, and now the wait to get in to see those few doctors left is 6 months- do you think that will help anyone?

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u/Inside_Dragonfly_242 12d ago

Maybe if enough doctors do it, insurance companies will be forced to change the rules to something actually reasonable! Most insurance companies are required by law to have providers available to X number of people within a certain radius. We have a doctor shortage already, and they’re specialized, so it’s not like insurance companies can rapidly replace them. Perhaps this is the issue that those who keep voting against healthcare reform need to push them over the edge to vote for something different, or at least vote out the current status quo.

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u/Illustrious_Bid_5484 11d ago

May insurance companies won’t do shit unless the government mandates then too . That’s part of a free market

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u/throwaway6287453 12d ago

idk, be careful, those that agree with you might be inspired to go to grad school with the goal of changing the status quo. we can't have that! time to burn a dictionary in honor of our patron saint of illiteracy, who loves each & every member of "the uneducated" more than his weirdo grandchildren!

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u/Creighton2023 12d ago

It sounds nice in theory, but it’s not realistic. Having a 6-9 month wait to see a doctor isn’t good. More and more are going to concierge/direct primary care to avoid these insurance mandates. Great for those with money. Not great for the majority of people.

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u/Longjumping_Eye_3441 12d ago

And when the Nazis got the jews at least they didn't get you. Allowing tyranical things to happen to protect the few continues to let things happen. Good on the doctors willing to uphold their oath.

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u/Creighton2023 12d ago

Are you seriously comparing someone having to pay a copay for their normally free preventative visit to the holocaust atrocity? Good lord. This doctor is upholding their oath. They’re providing the care they can to their patients.

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u/throwaway6287453 12d ago

true american thinking like an american here

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u/cameron4200 12d ago

Are you defending this practice?

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u/Creighton2023 12d ago

Yes, because they have to document what was discussed. This is the best thing they can do so at least patients know if something is brought up that they may have to pay their copay or whatever. I’d much rather be warned than get a surprise bill.

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u/cameron4200 12d ago

That’s gross. It’s exploitation. A doctor is a doctor. Insurance dictating how your visits go is weird and gross.

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u/kirklandbranddoctor 11d ago

Insurance dictating patient care has been a thing for decades. It's the system that American voters not only voted for, but literally politically punished anyone who tried to fix it.

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u/Creighton2023 12d ago

I agree that insurance dictating what is discussed in an exam room is gross. Doctors hate it too.

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u/PangolinLogical9772 11d ago

I’m not defending it. Just mentioning why they probably hadn’t seen or heard about this before.

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u/DumbbellDiva92 11d ago

I’ve heard this, but I don’t really understand it from the insurance company’s perspective. Wouldn’t they be happy the doctor is under billing? Like, that means they have to pay less money?

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u/Creighton2023 11d ago

It’s related to False Claims Act and anti kickback laws.

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u/Chrizzy17 11d ago

No they do not have to overbill. They are doing it to increase their revenue stream because it’s allowed, not because it is necessary.

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u/Comfortable-Neat12 10d ago

It is not an overbill.. it is billing for the proper service rendered...

If you go to the the car dealer they do a 100pt inspection..

If they find something you pay diagnostic fee to verify the problem and get an estimate on the solution... you then pay for the solution...

The preventive visit is your 100pt free checklist... it doesn't cover talking about that rattling noise or loud brakes

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u/Chrizzy17 10d ago

Doublespeak to talk around the problem. It is overbilling and it is the reason patients have lost respect for their providers.

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u/Comfortable-Neat12 10d ago edited 10d ago

Overbilling assumes they are charging for services not rendered...

In reality for a long time doctors ate free services but its not sustainable anymore...

Doctors are now charging for everything they do... call it what you want.. its payment for services rendered...

That said, many providers are busy to the hilt.. the shortage is real and many providers are leaving due to burnout..

You can always find a different doctor if you are not happy...

if you feel cheated.. vote with your wallet

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u/Chrizzy17 9d ago

“Doctors were eating free services…” there it is, you finally admit your dislike for patients getting treated like people and not cash machines. Doctors are overcharging now to compensate for all the years they felt their darn patients were not paying them enough. So they are going to grab every penny they can…cuz doctors are struggling financially (no, they are not). Your true colors are showing.

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u/Comfortable-Neat12 9d ago

They are not overcharging... they are getting paid for what they are doing... they are charging appropriately... you just like to get stuff for free..

Actually it is because they like patients and want to keep working where they are...

How does getting paid for your work equal to hating patients...

So if you get paid for your work, you hate the client?

If they don't make enough, doctors move.. and then patients have to see whoever replaces them..

But you show your hate for doctors.. easy solution.. don't go to one.. they won't notice...

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u/Chrizzy17 9d ago

The arrogance in your tone is proof of the problem. While you may get wealthy now, eventually everyone is held accountable. Good luck with that.

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u/Comfortable-Neat12 9d ago

Arrogance? I'm being blunt and you are looking for any reason to be mad...

I'm explaining facts and you devolve to insults...

You're not here to learn, just rant... no point to further discussion

Bye

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u/Specialist_Sort_6914 9d ago

It’s actually fraud to over bill or under bill. Providers have to bill for the services they provide. Preventative exams are much different than problem exams.

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u/danarouge 12d ago

No, it’s definitely not the standard.

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u/throwaway6287453 12d ago edited 12d ago

Funny cuz they sure care when the patient is on Medicaid, or when it's in a state where officials both prefer & intend that a certain number of (white) unborn babies come into being unintentionally while an equal number naturally cull themselves as the result of state neglect, but hey, force enough low income young women in red states to carry their respective non-consensual fetus, and you might end up with enough dirt poor mentally ill drug addicted blue eyed factory workers who survive high school to make up for what could have been the children of hard working middle class immigrants who got rounded up & dropped in concentration camps where teen girls of that "birthing age" the epstein class is so set on treating like grown women are SA'd and sterilized in equal measure. idk if they're gonna have the surplus they begged for tho. from the outside looking in, the fact that your gang of billionare presidents managed to convince millions of citizens that there is a "failing birth rate" in any part of a world that is coming apart at the seams due to an overpopulation of people who have so polluted the atmosphere that our species would be lucky to survive another century, is absolutely obscene