The federal government has granted itself potent new authority to expel physicians from Medicare if they are found to prescribe drugs in abusive ways, following through on a proposal issued earlier this year.
Tag Archives: reimbursement
Some of the country’s best doctors have the worst patient satisfaction scores.
Want to know why?
Part of training to become a fee-for-service doctor is learning how to suppress your feelings. You get good at being who people want you to be, not who they need you to be.
You’re slowly transformed into something you didn’t foresee–a Stepford doctor out to please everyone with a sycophantic grin and forcibly appealing demeanor, hoping that your patient satisfaction survey will be favorable, no matter the cost.
You call for an appointment and are told it will be about 20 days.
You arrive on time only to sit in the apt named waiting room for 40 minutes.
You see your primary care doctor (PCP).
You start to explain why you came in.
When Blue Shield of California was designing the new health plans it would offer individuals under the Affordable Care Act (ACA), the insurer made a simple request to doctors and hospital in its network — lower your prices or get left behind. The insurer asked providers to accept reimbursement rates as much as 30 percent lower than what Blue Shield previously paid through plans sold on the individual market. Keep in mind that billing through a third-party-payer is about to multiply tenfold in complexity (from ~15,000 to +155,000 billing codes with ICD-10), meaning that getting paid will require more work for fee-for-service docs. In fact, providers are attending training seminars, paid for out of pocket, to learn how to deal with this billing beast.
Some providers got on board with Blue Shield, but not all of them.