Do something good for others. I doesn't get any easier than this. The next time you go to the docs office, get lab drawn, get an xray or go to the hospital, save your benefit form from your third party insurance company or your receipt if you pay cash and spend five minutes typing it into this program here made for me by Deborah Peel. I want to know how much you are paying for your health care. You may just help someone get a break on their bill. So type in your info and go to my sister blog: Explanation of Benefits. You can even see how much I'm paying for everything.
That blog had been shut down.
It would be interesting if your posters added what was actually paid directly to the provider.
ReplyDeleteanon, the "allowed amount", is what is actually paid to the provider. The charge minus the discount equals the allowed price, which is what really matters, and all that I really care about.
ReplyDeleteHi! Love your blog. I'm a lowly premed and I was wondering if I could ask you a question. I have been working as an assistant to a hospitalist for some time now. Its been bad. I love the idea of hospital medicine, but I have seen the docs working themselves to death. The turnover for doctors in our practice is super high and I'm sure it has to do with the horrible schedules. We serve 2 hospitals (one is 800 beds and 1 is 200) and several nursing homes and LTACs with roughly 3 doctors and a locum at any given time. Is this a reasonable picture of what all hospitalists go through or does the mythical "shift work hospitalist" actually exist.
ReplyDeleteThanks!
Edit *I'm sorry its a 400 bed and a 200 bed.*
ReplyDeletewannabe, that sounds like an unsustainable program. I can assure you there are good programs and there are bad programs. I currently practice in your "mythical shift work hospitalist" program.
ReplyDeleteSometimes the actual payment to the provider ends up being less than the allowed amount due to other contractual write-downs. Not always though. So, the claim statement ends up looking a little different the "processed claim" statement.
ReplyDeletethanks! and it isn't sustainable, the turnover/burnout rate is ridiculously high.
ReplyDeletejimcmd, My definition of allowed is the final total price by the insurance company. What ever they end up paying is the allowed price (at least in my book) I don't know what else allowed would mean.
ReplyDeleteHappy
Happy, you might want to correct your date...unless you don't plan on doing any more posts until December (hope not...they're great)
ReplyDeleteHi Tony, the only way I can keep the post at the top of my blog for a long time is to fool the program into believing the "post date" is a date into the future. I picked the last day of the year as I figured it was far off into the future. It has no bearing on the rest of my posts, other than my side bar won't show all the current posts in the current month. You'll just have to click on the month to see what's there.
ReplyDeleteI'll stop posting when Mrs. Happy cuts me off.
Are you interested in information that doesn't include the numerical codes but just the general descriptions? "New patient visit", "ultrasound", "laboratory services", etc? Or are these data not very useful?
ReplyDeleteKD, The medical world operates on CPT codes. If you get anything done anywhere (unless you are paying cash price without insurance), every explanation of benefit form should have a 5 digit code for the service provided. If you've got stuff without a code, that would still be useful as well however.
ReplyDeleteHappy
I know that you're right about the billing codes, but the codes appear nowhere on my Explanation of Benefits forms. If I'd received copies of the forms the doctor submitted to the lab to order blood tests, I would at least know the right codes....but I still wouldn't know which one cost $16 and which one $60.
ReplyDeleteMy insurance plan (through my employer) makes things even more complicated, because some costs (office visits, radiology) are covered by BC/BS, while laboratory tests are covered by United Healthcare. All the lab bills go to BC/BS, are denied, and then get shunted to United. I end up with 3 or 4 pieces of billing/EOB forms for each time I get bloodwork done. Since I'm pregnant and hypothyroid....that's a lot of bloodwork.
I'll see what paperwork I can make sense of for your survey, though.
In the end, I won't be able to give you any insurance info anyway. The data entry webpage doesn't allow submission when the CPT code is left blank.
ReplyDeleteGood luck with your survey, though.
you can just type in zeros. That would work for me
ReplyDeleteHappy
Dr. Happy, I was the patient who sent info for Cedars Sinai in Los Angeles. In my case, the oncologist listed was not "in network" with my ins. plan, so my plan only paid a percentage of the Allowed Amount, with my doctor billing me for the difference. Don't know if patient co-pays makes a difference for your study.
ReplyDeletelady patient. It's good to know. Thanks. I'll make note of it.
ReplyDeleteDoes anyone else find the date of this post weird?
ReplyDeletedevorrah. The only way blogger let's you keep a post at the top of the page is to fool it by forward dating it. That's why the date is far off into the future.
ReplyDeleteThat makes sense--thanks!
ReplyDeleteAre you interested in Medicare patients as well? I don't receive any forms stating how much they have paid for the services I've received as a cancer and lupus patient but perhaps there are some forms at the hospital...Anyway, I'd love to help if my information would be of use to you.
ReplyDeleteMedicare patients are fine as well
ReplyDeleteI am looking at an EOB of 6 separate blood tests (no cpt codes) totaling $559.00. Insurance paid $382.36 Discount was $134.16 leaving a patient balance of $42.48.
ReplyDeleteWhat I find insane is that as the primary care doctor who orders the test, interprets the results and explains all to the patient, I am reimbursed about the same as one of the tests ($100.00). These tests are worth nothing without my interpretation and diagnostic acumen, but my skills and time involved are greatly under valued.
FWIW, (Toni MD)I can interpret my thyroid tests without my doctor (just as diabetics can interpret their blood sugars). I don't even go to my local lab for tests, I go to a walk-in where I can mail-order them. It costs me better than HALF as much to get the tests ($75.00 vs $180.00), and as an uninsured person that means a LOT. I need the tests (3-4 times a year due to flaky Hashimoto's), I need the doc to write the prescription for thyroid meds (wish thyroid patients could be treated like diabetics in this case too), but also need not to break the bank over it.
ReplyDeleteM - where are you able to do this?
ReplyDeleteI found you through the Happy Flu. I will be sending a tatt of mine, two actually that aren't all that interesting but in Latin nonetheless and since you all are in the medical profession you might be able to read it.
ReplyDelete