This blog will hopefully give other docs an inside look at the trials and tribulations of transitioning a busy solo family practice office to a third party and managed care free practice.

Wednesday, March 11, 2009

I should have been a Veterinarian !!

My day off. I took my dog to the vet for her annual checkup. 30 minutes and $175 later, I was driving home. They did not ask to see my insurance. They did not ask for a copay. They did not ask for an insurance referral. All they asked was for payment in full at the end of the visit. Cash, check or credit card please, Ka-ching!!!

The $175 breaks down as:

$50 for the exam
$61 for 3 vaccines
$48 for blood and stool test
$16 for a flea-tic collar

So if we look at it more closely, the bill is actually reasonable. And it was one stop shopping. Pretty convenient!!

Now let's compare to a managed care practice for humans.

You show up at the office and are asked for your insurance card prior to anything else. Once the insurance is verified, you wait to be called back to the exam room. If you need blood tests, the office must first check to see what lab your insurance participates with and whether the tests will be covered. Then you may be given a labslip to get the tests performed at a capitated laboratory.
Then you must wait 3-5 days for most test results.

Vaccines can be given. But with the insurer changing the rules frequently, the doctor does not know if he will get paid. If not, good luck getting paid afterwards by the patient. As for medications and treatments, you need to give a prescription for patient's to get filled at a local pharmacy, or a mail order pharmacy, which can take a few weeks to obtain.

After all this, the patient pays a copay, averaging $20-25. Then the doctor's office must submit a claim to the insurance company and hope to get paid within the next month or two, and not for the full amount, but a discounted rate.

It may just be me, but it sounds much easier and more efficient at the vet's office!!

And you wonder why I transitioned out of third party contracts!!

DoctorSH

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