Silicon Investor (SI) -- The First Internet Community

STOCKTALK

We've detected that you're using an ad content blocking browser plug-in or feature. Ads provide a critical source of revenue to the continued operation of Silicon Investor. We ask that you disable ad blocking while on Silicon Investor in the best interests of our community. If you are not using an ad blocker but are still receiving this message, make sure your browser's tracking protection is set to the 'standard' level.

Strategies & Market Trends : The Residential Real Estate Crash Index -- Ignore unavailable to you. Want to Upgrade?

To: neolib who wrote (199752)	5/3/2009 12:14:03 AM
From: i-node	Read Replies (1) \| Respond to of 306849

I already gave the example. I visit the Doc, he bills my insurance $60 (paper work required) they modify the price based on their provider agreement with the Doc, pay him their fraction, and send me a bill notifying me that I must pay the remainder. The Doc also sends me a bill for the remainder of the adjusted price. I mail him a check. Actually the process is more like this: - The doctor enters the charge lines into his system - His system electronically transmits claims to insurance carrier - Insurance carrier electronically transmits payment information to your doctor, where they automatically are posted to your account. - When the payment auto posts to your account, a statement is generated. Documenting this transaction, including all info required until the time your statement is mailed, in a clinic that is set up correctly, should be complete before you walk out the door. Now compare that to a drip to Safeway where I buy $60 of goods, and ask yourself what exactly your metric of efficiency is. Only if you conveniently ignore substantial portions of the transaction that you didn't ignore in your physician example. They're two different kinds of businesses, and the complexities are in different parts of the transaction. For example, Safeway has to relieve its inventory of the items you purchased. They will have electronic systems that decide whether more of any item needs to be purchased, purchase orders will be generated electronically and submitted to the vendor, when the order gets in it must be stocked, etc. It is pretty useless compare the accounting for a physicians office with that of Safeway, but I can certainly do it if I choose to.

To: neolib who wrote (199752)	5/3/2009 2:21:31 AM
From: bentway	Read Replies (1) \| Respond to of 306849

You left off several step in the process. The insurance co. clerk, on receiving the doctor's charges, denies coverage. The doctor's clerk resubmits - wash, rinse, repeat.. The insurance company won't pay for the doctor's preferred drug to treat you. They insist you use a less effective drug in their formulary. If you want to use the drug your doctor would have you use, you pay retail out of pocket. Same with the recommended diagnostic procedure they won't pay for. ..and on and on. 30% of insurance efforts are devoted to denying you coverage. Several office workers at your doc's are devoted to attempt to get it for you. Health care shouldn't be an adversarial, for-profit system. I REALLY don't feel like fighting battles when I'M sick! The only people who don't know or deny this are the parasites that profit from our broken system. Ask i-node what he does for a living..