Do Most TX Doctors accept assignment?
- Thread starter jody108
- Start date
- 2,103
I think that may indeed be correct, somarco. I have heard about doctors with signs on the door saying "no mapd fee for service plans accepted here" or something like that, however, I think that same doctor could accept a med supp with original medicare. I think.
I guess they get to choose which network they want to be in, and original medicare may be a good choice for most of them- it's tried and true. I guess.
I guess they get to choose which network they want to be in, and original medicare may be a good choice for most of them- it's tried and true. I guess.
I seem to recall, when I went thru MAP training a few years ago before taking a pass, that docs could in fact accept Medicare but opt out of carrier networks.
So if you had a Med supp, and switched to a MAP, you might have to find a new doc.
It is beyond me why docs are willing to accept 60 cents on the dollar with Medicare patients, then they claim they want "Medicare for all".
If you are a primary care doc who accepts Medicare your income really suffers. Which is why so many new docs are opting out of primary care in favor of specialties.
Somebody please explain this to the prez elect.
So if you had a Med supp, and switched to a MAP, you might have to find a new doc.
It is beyond me why docs are willing to accept 60 cents on the dollar with Medicare patients, then they claim they want "Medicare for all".
If you are a primary care doc who accepts Medicare your income really suffers. Which is why so many new docs are opting out of primary care in favor of specialties.
Somebody please explain this to the prez elect.
- 2,103
Well.... actually... I happen to be friends with a few docs. They are 100% in love with medicare and medicaid, any government program. Because.... they say that they get paid so fast by the government. I guess they would rather take a discount- and get paid quickly. They have told me they like government programs over private insurance companies. { which is of course fairly scary, but that's their opinion}
- Thread starter
- #15
- 707
that is good to know ...
- 1,908
that's nice to know...
However, though, that's not all together true. Your doctor friends are: either in the minority, or are just pulling your leg. Doctors, just like all other folks, don't have the time to do the due diligence of Medicare Advantage and Medicare Supplement Plans.
In actuality, the physician is reimbursed within 30 to 45 days from a Medicare Advantage Plan, because they are dealing directly with the insurance company, who pays first, then they, the insurance company, files with Medicare, and waits for reimbursement. Which, in and of itself is not the truth, because CMS prepays the insurance company an outrageous amount per month, to take care of the Medicare Beneficiary.
If the physician bills Medicare directly, the waiting period for reimbursement expands to 90 to 120 days. Which cuts drastically into the appeals process that each Medicare Beneficiary has a right to. (this means it can take up to 90 to 120, not that it will - for those of you who were about to call me on the carpet for that statement)
Doctor's are not working with Medicare Advantage plans, primarily, because most of the companies that represent these plans (Universal, Pyramid, Arcadian, etc.) are not known to these physicians, and they are not going to use their resources (staff), nor their time to forge a relationship. They had too much to do, as it is, treating their patients, keeping up to date on the latest drug, leasing equipment, hiring/firing staff, etc.
The Medicare Advantage Plans that will survive, after the shakedown, will be the companies who also offer Major Medical coverage (Blue Cross, Humana, Coventry, UHC, etc.) for no other reason than the physician has already worked with their billing department, and the transition is seamless.
Let me drive the point home: How many of us "insurance agents" take the discount card programs (IAB, Family Care, etc.) seriously? A very small number, I guarantee you. Also, if you were to do a search on any of these plans, you will find that most of us talk about how much harm they do vs. what value they offer those that need/can use them, due to an uninsurable diagnoses (Cancer, Diabetes, Heart Attack, etc.).
Doctors are no different.
In the IFP market, I've come across those that tell me that their doctors tell them NOT to get insurance, because they will cut them a deal, if they pay direct.
Anyone believe that?
"Listen, we're about to do an EKG. Rather than charge you UCR, I'll let you have it for $45, if you pay me cash, now."
Yeah, right.
I recently asked John Oxendine, Georgia's Insurance Commissioner, and Gubernatorial Candidate, about this very same topic.
His retort: The problem with the Medicare Advantage Plans, is that you have "two cooks" in the kitchen. The DOI regulates the insurance aspect of it. CMS regulates the dispensation of it. There needs to be only one who regulates it, and right now, neither party wants it.
Getting back to the "accepting assignment" question: The doctors who want the Medicare Beneficiary to be more involved in their treatment options, and not run to the doctor for every little thing, don't accept it, so that the MB will have to pay for abusing the system. Those that do, feel they are there to service a segment of society that is "entitled" to this service, and has paid into it fairly and justly.
Hopping back on my throne.
- 2,103
This person I speak of is 100% for a complete univeral healthcare system for all, and dislikes all private health companies, and big pharma companies -and is in love with the government. There are people like that out there. I would have figured they would be more conservative in nature, but nope. It takes all kinds of people- in the world. I still like them, even if I have a different viewpoint. I do think the health insurance industry does need some sort of overhaul, just not a complete government takeover. Just my opinion. But, for now, we have the medicare system like it is, for now.
