Once you sign an agreement, there’s not much a patient can do:
Bonnie Berry was also initially charged $290. The charge was made to a credit card belonging to her sister, Martha Green.Remember, Bonnie had a cut finger but she says the doctor told her she also has high blood pressure. “The bottom line was, he wanted an additional $1,400 and something dollars to treat me. I told him that I couldn’t afford that. I just wanted my finger stitched.”
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{ 8 comments }
Sounds like this doctor could use some competition, maybe with charges posted on a waiting room menu, with stated minimums and amounts not to exceed on a single visit without further notice.
His charges for minor surgical services are steep. Of course, the story is biased in that it does not say how much the patients were able to be reimbursed by their carriers. That is relevant to the whole story, if you are trying to make the case that his charges are truly excessive (Where does he get the $6,000+ for treating blood pressure and a puncture wound? He must be padding the account with lawyer charges and other “collections” costs.)
But if you go in to a cash-pay convenience-oriented urgent care center and throw down your credit card and act as if you don’t care what the charge is, and you don’t bother to ask, then you really can’t say you object on the grounds that you were charged more than quoted.
I would venture that many people who freely consume what their insurance company pays for with little more than a copay would be surprised at the costs of their consumption if it came on their dime, even at discounts typically enjoyed by insurance plans. Some might even be shocked.
The dimwits need to ask up front what the charges will be and if the doctor refuses to tell them then go elsewhere. Common sense.
The purpose of “Opting out” of insurance plans and medicare-medicaide is to eliminate the costs of getting fair and appropriate reimbursement for your services – not to get rich from the services you render.
If you are going to ask and expect that patients pay cash you need to keep your services within the boundaries of the already established fee schedules for that procedure you perform.
Furthermore, if you do invasive procedures in your office, such as injections and surgical procedures, then you will have to lower your rates to adjust for what patients can reasonably afford. This may involve trusting them to pay you over time even when you factor in your discounts.
If you are busy you do not need to maximize profit. If you aren’t busy – don’t opt out.
Asking your patients to pay more than standard fee guidelines is inherently unfair to them, makes you look bad and probably will spell economic failure for your practice, in the long run – or even the short run.
Provide good care, charge equitable fees, be nice, be competent, be concerned and have fun enjoying your patients.
Credit cards are for Macy and Gimbel, not Doctor Kildaire.
I am in practice Dr. Mangino, and I disagree with you.
As long as you are willing to state your charges, and charge for only what you do, then it is your privilege to charge what you like for your work. Keeping your charges in line with what some insurance company wants to reimburse is not required. I don’t owe it to anyone to limit what I charge, or to demand a higher charge than is commonly reimbursed if I think that is a fair rate to compensate me for my time, risk and materials.
How a doctor chooses to accept payment is his business. Cash is fine, so are credit cards. If you want to take Medicare and think that is fair compensation, then go ahead.
If not, then charge what you want.
This doctor was working on a cash-pay basis. Although his prices may have been high, as long as he was not charging for things he wasn’t doing, than that is his right. No one compelled his patients to go to his walk-in clinic, we can only assume they went there by their choice.
I don’t think anyone will guarantee this doctor riches from his practice; he will have to attract business in the way one has to in a market. At the same time, he does not have a moral obligation to toe the arbitrary price line set by Medicare or some insurance company
that has its own agenda in the medical market.
Dear Anon 1:12.
I am sure-knowing how lots of doctors think- that you all would not agree with what I said.
I stand on what I said in my original discussion of this issue. I don’t need an economic lecture or “I do this or that.”
To me-it’s a philosophical issue. I charge what patients can afford-period.
Be well, Bill Mangino, M.D.
I have managed clinics for 10 years and charging up front is the best way to do business becuse 1/2 the people dont pay thier bill and then we have to send them to collections. I agree though ask what are the charges before hand on what procedures are to be done and if you dont agree go and wait at the county hospital for 6 to 12 hours …
Dear Anonymous,
I did refinancing home mortgages for 15 years & doctors had the most debt & the worst credit over all. What do you have to say about that truth?
People think they know it all. Doctors dont take cash anymore. They cant even tell you how much it will cost for the office visit. You can get an appointment, if you insist, without insurance, but they cant give you a price. Its like going to a fancy restaurant with a $20 in your pocket and being expected to order without looking at a menu only worse. I challenge anyone to call their own doctors office and act like a new patient without insuranace and wanting to pay cash. You will be shocked at the direction the bureaucracy has taken us.
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