Jump to content
RemedySpot.com

Re: profit

Rate this topic


Guest guest

Recommended Posts

I found this online.

Occupational therapy oath

As an occupational therapist I will revere the quality of life as life itself, assist all who request my help according to my ability and judgment; provide sufficient information to enable my client or those responsible for my client to make informed decisions regarding my client, sharing only with those others who are immediately involved with my clients' care; be goal directed and objective in my evaluation and intervention but above all I will be with my client in the stress of evaluation and the work of intervention; make only recommendations that I judge as being beneficial to my client, maintain my competence and represent that competence accurately; accept my own limitations and when indicated seek the assistance of those with different or greater knowledge and skill, ask only a reasonable fee for service; take responsibility for participating in formulating the policies and standards of my

profession; build upon the knowledge and skills with those who will follow through publication and teaching; respect my colleagues to the extent that they deserve my respect; sanction those colleagues who are incompetent or unethical in practice; be accountable for all my decisions and actions.

To the members of my profession and the society to which I am responsible and serve, I make this pledge with full understanding of the actions required by this oath.

I am going to leave it at that because honestly I give free advice to people who are struggling in 3rd world countries dealing with the same issues we are dealing with our kids. Imagine they are all considered mentally handicap. They have no idea what Autism is.The saying goes that the grass is greener on the other side but our little community is growing really big now. We fight amongs ourselves for services. Its only going to get worst. Either we can bitch about it and place blame on this or that. Or we can stop feeling sorry about everything and just deal with what we have been given. If you havent notice our healthcare is a business. Its not the people working in the medical fields that made it that way. It is the way our system works out right now.

To: sList Sent: Wed, January 19, 2011 2:39:10 PMSubject: Re: profit

Ok. However, please realize that some providers also have their own families to support. The medicaid reform has hindered not only families with children needing services but also the providers that need the income to feed/clothe their own families and buy durable goods. Everyone is hurting now - not that I am promoting the incredible amounts of money that some charge. I am a therapist and also a parent of a child with autism and have difficulty getting Medicaid to reimburse me for all the therapies that I do provide for children and it is not much money to begin with. If you add in all the time you have to spend in phone calls, billing, paperwork, expenses etc some companies have to charge more. I don't but I am also unable to hire anyone and pay them a wage. The health care system is broken in every sense and now they want to repeal the vote. I'm exhausted with all this.

To: sList Sent: Tue, January 18, 2011 6:02:40 PMSubject: Re: profit

I think the health care industry should be completely not for profit!

profit

In my 10 years of dealing with an autistic child the thing that stands out most is the number of people trying to profit from it like it's some kind of growth business.

Link to comment
Share on other sites

No, it takes a doc who feels so much sympathy for your situation, that

they are willing to help a patient commit insurance fraud hoping they

won't be caught.

If you have an insurance policy, you have a legal contract with them.

You both agree that for your premium payment, you agree to certain

conditions. One of those conditions is that if the charge is $A on a

covered expense, they will pay $B and you will pay $A-$B (or your

copay). If you get to renege by being let off that deal (waiving the

copay) the insurance company gets to be let off that deal. Any other

arrangement is ILLEGAL for a patient who is asking the insurance

company to pay, and ILLEGAL for your doctor to agree to help you.

Your doctor says the visit is worth $100. The insurance company pays

$80 and you pay nothing. That means your doctor, by accepting that,

agrees the visit is paid at $80 but tricked the insurance company into

paying all of it, not 80%. That is fraud. The government and

insurance companies are *very clear* about that.

Your doctor is hoping he/she will not get caught. He/she is legally

required to collect a copay. If you do not pay at the time, they are

legally required to make a " good faith effort " to bill you and try to

collect. What that good faith effort is, is up to interpretation.

But at the minimum, they need to bill you a few times. The person

they have to convince that they made a good faith effort is the

insurance investigator. If they are found to do this improperly, the

consequences are usually 1. having to repay all the insurance payments

on these visits 2. interest on the money that was paid out 3. fines

and penalties 4. disenrollment from the provider list 5. being barred

from rejoining, 6. being reported to the National Practitioner's Data

Bank, where other insurance companies, patients, and the medical board

(putting their license at risk) can see it 7. possible prosecution.

For you, the consequences possibly are 1. being disenrolled from your

insurance, 2. being barred from getting more from that company 3 (I do

not know but suspect there is a way for them to report it to each

other) 4. possible prosecution.

Insurance companies sometimes send " secret shopper " type patients in

to doctors' offices as quality control, but also to catch these

problems. Medicare, for example, will come in periodically and pull a

random percentage of charts looking for billing problems and other

signs of fraud. If the doc is found to have committed fraud, they

have to pay back all the money (all at once) plus interest and fines.

Medicare fines have lots of zeros, like $5,000 to $50,000 per

incidence, so each time a co-pay is not connected, that is one

incidence.

If the doc disagrees, he can appeal--to the person who did the audit

in the first place. The other catch is the auditor gets a percentage

of everything that is found to be fraudulent.

So by asking your doc to waive your copay, you are asking your doc to

put their entire livelihood and career at risk.

http://www.hcpro.com/REV-46459-2477/Beware-of-waiving-copays-and-deductibles.htm\

l

http://ezinearticles.com/?Can-You-Not-Collect-Or-Can-You-Waive-Patients-Copay

?-All-About-Copays-and-Copayments & id=1321839

>

> It is not true that doctor's can't charge differently for cash or

> self pay patients because I have been to doctors that have. I have

> also been to doctor's that have waived my copay...it just takes heart!

>

>

>

>

> Subject: Re: profit

> To: sList

> Date: Wednesday, January 19, 2011, 8:03 PM

>

> honestly, I have very little respect for the way DAN doctors decided

> to charge their patients. there's absolutely nothing that they do

> that warrant a $500 consultation fee. I know that people choose to

> go to them and agree to pay what they ask, but that's not an excuse

> for them to take advantage. There're parents that can't afford the

> consultation and go anyways, borrowing money, using credit

> cards...because they believe they must try anything and everything.

> The fact that none of them take insurance isn't an excuse either,

> since all docs complain of how little insurance pays anyways. And

> the explanation that they can't charge differently for out-of-pocket

> patients is a great one...hospitals can offer patients discounts,

> financing plans...why can't they? When I told one DAN doctor that

> the fees were so high, I heard " well, but it's your kid, you want

> the best for him, right? " no offer of splitting the $450 in 2, or

> anything like that...This whole business is a shame...

>

>

> >

> >

> > Subject: profit

> > To: sList

> > Date: Tuesday, January 18, 2011, 9:43 AM

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> > #yiv653257281 p {margin:0;}

> >

> >

> >

> >

> >

> >

> >

> > In my 10 years of dealing with an autistic child the thing that

> stands out most is the number of people trying to profit from it

> like it's some kind of growth business.

> >

>

>

>

>

> ------------------------------------

>

>

Link to comment
Share on other sites

I got reimbursement $500 (Which I did not expected) reimbursement our of the

$600 first time consultation fee from my insurance company using Dr. Bradstreet

and Rosignol at ICDRC, It was more than worth it. They spent over 2 hours with

my son, when I got there I could tell that they spent a lot of time previously

looking at my child's intake form and medical records. They did all the testing

on our first visit at their in-house lab with the kids friendly needle, provided

me with an invoice with codes to submit to my insurance, worked with the

in-network labs who covered the testing, did not push me for unnecessary

tests... by the second visit I got all the lab results, a treatment plan, they

give you a lot on your first visit.. Some Doctors may not charge that much but

start the treatment very slooowly making you go several times ending up being

more expensive. I went to one before " saving money " who put me on the diet for

months... which did not work because my son has a bid reaction to egg! And I

have to ask for testing and they sent me home with some kits to do them myself!

But at least these DAN doctors do something and give you hope, the Neurologist

we visited for about 30 minutes charged my insurance $500 for the visit, do not

even looked at my son, just asked us few questions and gave us a letter with the

" Diagnosed " that we already had!

I believe parents are willing to pay for whatever help their kids, sad part is

when you pay for something that is not working or to see a therapists doing

something that you can do better and at home and they charge $$$ for it! Many of

us have to work many hours to pay for 1 hour of therapy, we want that time to be

worth it, even if is paid by the insurance! Sometimes is not only money, it's

your time, and time you take away from your child to be at the park with their

friends!

> >

> > From: kingmeerkat@ <kingmeerkat@>

> > Subject: profit

> > To: mailto:sList%40yahoogroups.com

> > Date: Tuesday, January 18, 2011, 9:43 AM

> >

> >

> >

> >

> >

> >

> >

> >

> >

> >

> > #yiv653257281 p {margin:0;}

> >

> >

> >

> >

> >

> >

> >

> > In my 10 years of dealing with an autistic child the thing that stands out

most is the number of people trying to profit from it like it's some kind of

growth business.

> >

>

Link to comment
Share on other sites

Join the conversation

You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...
×
×
  • Create New...