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Had my free Obamacare annual preventative screening exam 2 weeks ago and the doctor's office charged me a $35 co-pay. Said I discussed stuff with the doctor that wasn't included in a screening exam. Of course, I got pissed off at them. Here's my e-mail.

This happened to me last year with regular insurance, resulting in a $30 charge to us above and beyond our free preventative annual exam. Best $30 spent ever, since it caused me to dump that doctor and find another.

I had failed to mention in my questionnaire the arthritis I have in my big toes, which had been diagnosed and backed up with Xrays by the ortho I went to a couple of years earlier, remembering to add it during the exam. An issue that resulted from cramping of toes from insufficient Mg, self diagnosed and something I have since resolved without DR input, since their best approach was a steel plate in my shoes which would restrict toe movement and impede my active lifestyle. When I called to complain about the "new" diagnosis, pointing out the prior documentation, the insurance co declined to back me. Their bad. I didn't know about the State Insurance Commissioner, so My Bad. That same DR had fought me tooth and nail about getting my labs done at an independent lab, trying 5 times to send me to the way more expensive hospital lab she was affiliated with until I literally screamed at her over the phone and she gave in and faxed in the lab orders.

I love my new doctor, so I guess the PITA Dr intermediate was worth the hassle.

IP
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No. of Recommendations: 2
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Had my free Obamacare annual preventative screening exam 2 weeks ago and the doctor's office charged me a $35 co-pay. Said I discussed stuff with the doctor that wasn't included in a screening exam. Of course, I got pissed off at them. Here's my e-mail.



Wow, I actually got a surprise billing at the hospital when I took wife for a CT and dye scan yesterday morning! Would you believe C$7.50 for less than two hours parking! Last time I was there it was $1.50 an hour ... about five years ago.

Go get them, I'm cheering for you. }};-D

Tim
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Yes Tim we are aware that everything is better in Canada.If you keep reminding us we might move in.


JK
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You wear that smirk really well. Have you had it long?
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I have a former employee who now lives in Sweden. Long story made short, she was diagnosed with a cancerous spleen. She was immediately operated on and then spent a few weeks in a rehab facility. He only cost was the taxi from the hospital to the rehab place - which she said she could recoup by writing a letter, but it wasn't worth her time.

In the industrialized nations, the US seems exceptionally challenged by health care issues. Good health, paid for and guaranteed y the government (through taxes) is too socialist a concept for our capitalist nation (but keep your grubby hands off my Medicare and Social Security)

Jeff
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No. of Recommendations: 4
Had my free Obamacare annual preventative screening exam 2 weeks ago and the doctor's office charged me a $35 co-pay. Said I discussed stuff with the doctor that wasn't included in a screening exam. Of course, I got pissed off at them. Here's my e-mail.

This happened to me last year with regular insurance, resulting in a $30 charge to us above and beyond our free preventative annual exam. Best $30 spent ever, since it caused me to dump that doctor and find another.

I had failed to mention in my questionnaire the arthritis I have in my big toes, which had been diagnosed and backed up with Xrays by the ortho I went to a couple of years earlier, remembering to add it during the exam. An issue that resulted from cramping of toes from insufficient Mg, self diagnosed and something I have since resolved without DR input, since their best approach was a steel plate in my shoes which would restrict toe movement and impede my active lifestyle. When I called to complain about the "new" diagnosis, pointing out the prior documentation, the insurance co declined to back me. Their bad. I didn't know about the State Insurance Commissioner, so My Bad. That same DR had fought me tooth and nail about getting my labs done at an independent lab, trying 5 times to send me to the way more expensive hospital lab she was affiliated with until I literally screamed at her over the phone and she gave in and faxed in the lab orders.

I love my new doctor, so I guess the PITA Dr intermediate was worth the hassle.

IP
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No. of Recommendations: 13
inparadise writes,

<<<Had my free Obamacare annual preventative screening exam 2 weeks ago and the doctor's office charged me a $35 co-pay. Said I discussed stuff with the doctor that wasn't included in a screening exam. Of course, I got pissed off at them. Here's my e-mail. ....>>>>

This happened to me last year with regular insurance, resulting in a $30 charge to us above and beyond our free preventative annual exam. Best $30 spent ever, since it caused me to dump that doctor and find another.

</snip>


I don't think my doctor did anything untoward. He's just an employee in a large medical billing operation.

About 5 years ago this shop brought in an MBA "Medical Administrator" and likely got Private Equity money to greatly expand the size of the operation. Shortly thereafter, they bought a good-sized strip mall a couple of miles from headquarters and used it to house their new Medical Coding Dept. As I understand the process, the doctor writes stuff in your chart and then it's handed off to the Medical Coding Dept to wring as much revenue as they can out of the chart through aggressive coding decisions. Say you have a pain in your knee during the screening exam, you might get charged for the possible diagnoses and referral for arthritis. Admit that the COVID lockdown has you feeling a bit blue, you could be dinged for a psychiatric referral. It all depends on the diligence and creativity of the medical coder who, no doubt, gets a bonus for finding stuff in the chart you can bill for.

I suspect a lot of people are unaware that this is the way the game is being played these days and are just paying the bill without complaint.

That's why whenever I call the doctor's office or insurance company with a billing problem, I end the discussion with the same sentence. "Is this something I have to file a complaint with the Washington State Insurance Commissioner to fix?". They really hate that.

intercst
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If you keep reminding us we might move in.


JK



No you won't, brutal winters and no second amendment. }};-D
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No you won't, brutal winters and no second amendment. }};-D

I rather suspect the weather in Windsor, Ontario, is much like that of metro Detroit.

Steve
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"I rather suspect the weather in Windsor, Ontario, is much like that of metro Detroit."

Exactly. Like Tim said - brutal winters...

Unlike Texas, where we have brutal summers.
But I'll take that over cold every time.
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I rather suspect the weather in Windsor, Ontario, is much like that of metro Detroit.

Steve


Well Windsor is south of Detroit and the vast majority of Canada but you still can't walk around with a loaded assault rifles. There is also construction and even art work towards a long delayed bridge going on.

Tim <wonder how the wall on the border with Mexico is doing?>

https://windsor.ctvnews.ca/gordie-howe-international-bridge-...
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Said I discussed stuff with the doctor that wasn't included in a screening exam.

So you "obviously" went from screening to treatment/education/whatever. Ditto with all these "free" colonoscopies. Take a look and do nothing, all free. Take a look, hey, there is a polyp/mass we need to biopsy. Probably will cost you something.

Make stupid rules get stupid results.

TINFL.

JLC
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Exactly. Like Tim said - brutal winters...

Oh I live in the warmest province in Canada? I am originally from one of the coldest parts of Canada (Northern Ontario). I left at just 17 and had no interest in ever going back when we returned from Germany. It was an easy choice as it is wife's home town and I had lived there for many years in my Sea King days. When it snows I look out my fifth floor window and comment on how pretty it is. My car is in a nice warm underground garage and we have a big high school behind us so the streets are promptly cleared.


Tim

https://www.moving2novascotia.com/blog-posts/whats-the-weath...

What’s the Weather Like in Nova Scotia?
What surprised us most when researching Canada was the weather and how it varied from province to province. Most people think of Canada as very cold, but don’t realise that we have very hot summers too. When choosing a move to Canada, our main weather request was that our province of choice had four definitive seasons. We were fed up of all the seasons rolling into one and the rainy gray days of Cardiff.

Nova Scotia’s Climate
What we love about Nova Scotia is that the weather here certainly ticks all our requirements. We have four true seasons, with snowy winters, warm, sunny summers and a mild autumn and spring. In fact, our province of Nova Scotia is actually on the same latitude as Northern Italy and is the warmest Canadian province.


OT - Inevitable story. I was working Squadron Ops one evening when a Georgia Air National Guard Herc diverted to Shearwater in a blinding snow storm. I arranged a meal, quarters and fuel while their skipper commented that I guess we are stuck here for awhile. I told him to be here for 8am brief and he would be out of here by 10. He couldn't believe we had the base up and running with time to spare for his 1000 launch.
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JLC writes,

Said I discussed stuff with the doctor that wasn't included in a screening exam.

So you "obviously" went from screening to treatment/education/whatever. Ditto with all these "free" colonoscopies. Take a look and do nothing, all free. Take a look, hey, there is a polyp/mass we need to biopsy. Probably will cost you something.

</snip>


Actually that's not true, though I've seen many doctors misinformed on the issue of colonoscopes. It's surprising on the ignorance within the profession on a relatively common preventative screening procedure.

The ACA colonoscopy includes snipping out any polyps found and the pathology studies required to examine the tissue sample. The reason being is that fewer people would take the financial risk of getting the screening if there was a chance they'd be "surprised billed" a $1,000 or more to identify a benign polyp.

I actually won a positive ruling from the Washington State Insurance Commissioner back in 2014 when I had my colonoscopy. I called my health insurer ahead of time to confirm that they understood that a screening colonoscopy included snipping any polyps found and the pathology work required. The insurer's customer service rep told me that wasn't true and I'd be billed extra for the polyps and pathology.

When I got off the phone with the insurer, I immediately call the Insurance Commissioner's office and relayed what Blue Cross told me. The guy on the phone groaned and said "we've already told them several times they can't do that" and took my complaint.

I got a call the next day from a BlueCross VP with the news that certainly if any polyps were found they'd be taken care of without cost sharing. A letter confirming that arrived the next day from the Insurance Commissioner's office.

As it happens, I had a "clean" colonoscopy with no polyps found, so it wasn't an issue for me. But given that the profession is now seeing the ACA screening guidelines as a "surprise billing" opportunity it's best to get your ducks in a row before you see the doctor.

intercst
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"I got a call the next day from a BlueCross VP with the news that certainly if any polyps were found they'd be taken care of without cost sharing. A letter confirming that arrived the next day from the Insurance Commissioner's office.

As it happens, I had a "clean" colonoscopy with no polyps found, so it wasn't an issue for me."


Well, they told you that it was "clean". But perhaps they weren't about to find anything they wouldn't get paid for? Maybe they just ignored them as 'probably benign'.

Because that's the kind of society we are.
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Neuromancer writes,

"I got a call the next day from a BlueCross VP with the news that certainly if any polyps were found they'd be taken care of without cost sharing. A letter confirming that arrived the next day from the Insurance Commissioner's office.

As it happens, I had a "clean" colonoscopy with no polyps found, so it wasn't an issue for me."

Well, they told you that it was "clean". But perhaps they weren't about to find anything they wouldn't get paid for? Maybe they just ignored them as 'probably benign'.

Because that's the kind of society we are.

</snip>


No. The doctor and pathologist get paid by the health insurance company if polyps are found. It's actually in their financial interest to do a thorough exam and find as many polyps as possible. I believe the gastroenterologist community calls it "probing for gold" since they get paid about $100 extra for every polyp they snip in a colonoscopy.

intercst
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So you "obviously" went from screening to treatment/education/whatever. Ditto with all these "free" colonoscopies. Take a look and do nothing, all free. Take a look, hey, there is a polyp/mass we need to biopsy. Probably will cost you something.

Make stupid rules get stupid results.


I don't understand the logic. The "free" colonoscopy is a paid-for benefit that comes with purchasing that specific insurance policy.

It seems to me if the benefit is paid for in advance, you ought to actually receive that benefit. I'm scratching my head trying to figure out why getting what you paid for is stupid.
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No you won't, brutal winters and no second amendment. }};-D

I'm going to check that out later next year. #2 son is now living in the U.P., forecasting weather for the Lake and the UP area. He's looking forward to 100" to 200" of snow this winter.

FWIW: He doesn't care about the 2nd amendment, nor does the rest of the family.
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I'm going to check that out later next year. #2 son is now living in the U.P., forecasting weather for the Lake and the UP area. He's looking forward to 100" to 200" of snow this winter.

100" is no big deal. I remember living in the west Michigan "lake effect belt", when Muskegon, which is on the Lake Michigan shore, would routinely get 100+" Notice how Buffalo always makes the news for it's unreasonable snowfall? Same lake effect going on there as in west Michigan.

Then there is the fun of an "Alberta Clipper" screaming in off the lake.

Alberta clipper

The storms sweep in at high speed over whatever land they encounter, usually bringing with them sharp cold fronts and drastically lower temperatures. It is not uncommon for an Alberta clipper to cause temperatures to drop by 16 °C (30 °F) in as little as 10 to 12 hours. Often, the storms bring biting winds with them, only increasing the effect of the lower temperatures. Winds in advance of and during an Alberta clipper are frequently as high as 56 to 72 km/h (35 to 45 mph). These conditions would cause wind chill values to drop into the -30 to -45 Celsius (-20 to -50 Fahrenheit) range.


https://en.wikipedia.org/wiki/Alberta_clipper

A number of years ago, a coworker was being transferred from metro Detroit to Grand Rapids. I asked him "do you like snow?". He said it didn't bother him. I said "good. remember last winter, when people here were crying a river about 40" of snow? Grand Rapids gets twice as much". He looked at me like "HUH".

Steve...wonders what the weather is that Tim is complaining about
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Well, they told you that it was "clean". But perhaps they weren't about to find anything they wouldn't get paid for? Maybe they just ignored them as 'probably benign'.


I've only every had one colonoscopy (family doc insisted). The guy doing it was head guy for NS, he did snip two benign polyps along the way but he had a CRT set up so I could watch the whole show and it was like he was giving me a tour with his commentary. Though occurs that he may have taught the subject and was practicing? }};-@

I recall posting on it at the time because there was controversy over the two pill prep being used south of the border that we (he for Nova Scotia) hadn't approved because of reports of kidney damage.

Tim
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FWIW: He doesn't care about the 2nd amendment, nor does the rest of the family.


Yes, I know it isn't everyone. It is just that the international press had a ball with the TV reports of the guys 'practicing' open carry in the Michigan legislature(?).

Southern Ontario and Northern Michigan do get massive snow storms usually blamed on "Lake Effect". We in Nova Scotia get some real dandy's as well but not nearly as often.

Tim

https://g.co/kgs/7Jngtj
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Steve...wonders what the weather is that Tim is complaining about

No idea what you are talking about, I'm retired and hunkered down in my fifth floor condo. Temp going up to 7C today. We have had one small 2cm dusting so far.

Man did this thread ever get 'wandered'!

Oh well, might as well add to the mess.

Anymouse

https://globalnews.ca/news/7490565/canada-blocks-prescriptio...

Canada blocks key prescription drugs exports after Trump import plan risks shortages

By Steve Scherer Reuters
Posted November 28, 2020 4:21 pm

Canada on Saturday blocked bulk exports of prescription drugs if they would create a shortage at home, in response to outgoing U.S. President Donald Trump’s efforts to allow imports from Canada to lower some drug prices for Americans.
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