Health costs climb as physicians use self-referrals to order needless scans
In August 2005, doctors at Urological Associates, a medical practice on the Iowa-Illinois border, ordered nine CT scans for patients covered by Wellmark Blue Cross and Blue Shield insurance. In September that year, they ordered eight. But then the numbers rose steeply. The urologists ordered 35 scans in October, 41 in November and 55 in December. Within seven months, they were ordering scans at a rate that had climbed more than 700 percent.
The increase came in the months after the urologists bought their own CT scanner, according to documents obtained by The Washington Post. Instead of referring patients to radiologists, the doctors started conducting their own imaging -- and drawing insurance reimbursements for each of those patients.
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9 comments:
Let me get this straight, if a physician decides to make a sound business decision by investing in their own equipment and facility thereby recouping the facility fee from insurance they are bad guys? Tests are required by insurance companies but most are done to avoid lawsuits. TORT REFORM not physician witchhunt.
Oddly enough most insurances will approve self referrals, but if you refer to an outside facility they may are more likly to deny reimbursment. Although lets face it, if you had to pay for the equipment, your going to use every excuse to use it.
Criminal
Ok, let me get this straight it is unethical and immoral for a physician to own their own ancillary equipment to perform necessary tests such as x-rays, echocardiograms, EKGs etc., and expect to be paid for services rendered. All such testing should be referred out to an intermediary facility that no doubt would charge significantly more to perform the same test by having to register the patient, perform the test and pay a third party to interpret the test. Do I have this right? Now lets say the patient is you, Joe Liberal who needs to have a chest x-ray and EKG performed. Rather than performing these tests at that time in the same office and the physician immediately interprets the test and discusses the results with Mr. Liberal, Mr. Liberal is told that he has to travel across town to another facility for the tests and wait a week for the results. Yeah, that is a much better system. In some ways I can't wait for Obamacare to begin so that I can sit back and watch as Mr. Liberal bitches and moans as he waits in long lines to see the Doc of the day, has necessary tests denied by the government, takes second rate medications and wishes for the good old days.
What is wrong with this? It's more convenient for the patient. In addition to the new scanner the doctors certainly received more advanced training, and probably then realized they should have previously been ordering more scans and were probably mortified by who may have "slipped through the cracks" and the repercussions that could have for the overlooked patient. I would prefer a doctor to error on the side of caution and scan me if they see the need, instead of waiting and getting a scan a year later indicating I have a tumor that has progressed to the untreatable stage and then wait to die from a what could have been treatable issue.
There is nothing wrong with the doctor's office owning the equipment. The question is about whether or not they are now doing scans "just for the money"? Right?
That's how I read the article.
I don't what the hype is about, I just receently got a physical and some lab work, BC/BS of MD statement to me said the charge for lab work was $125.00 but $78 was reduced by LabCorp and they only got paid, that's right $47.00-including my deductible. That's crazy-you're complaining about Dr's billing and get reimbursed way less than the lab charges. Even with this info, I do not-I SAY AGAIN-DO NOT- want the gov't running my health care.
The Washington Post is following Obama's lead (you know the evil tonsil removal scheme) in villifying doctors to justify the government having complete say over medical procedures. How many government run programs are in the toilet? Cash for Clunkers, The USPS,Freddie Mac and Fannie Mae, who the hell wants the government determining medical treatment other than the socialist liberals? Blunt tried to pass a bill requiring ALL government employees and politicians use any government plan same as the public and the DEMOCRATS voted it down today. Fine for thee but not for me hypocritical POS.
1:41 pm Right, That's how I read the article also!
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