Do doctors reject patients that offer to pay out of pocket?

[Robbie Cottam]

So how do the doctors who don't take insurance and only take cash work??

You pay then with cash or credit card….
Usually, they only provide services such as mental health, or cosmetic surgery….

Usually, they bill at TOS or just after….. if your credit card is declined you don’t book your next visit until it is paid

 

[tvguy]

You pay then with cash or credit card….
Usually, they only provide services such as mental health, or cosmetic surgery….

Usually, they bill at TOS or just after….. if your credit card is declined you don’t book your next visit until it is paid

Yup, you write a check, lay out the cash, or use your credit card at time of service.
My issue now is my Medicare Dental/Vision/Earing supplement is not accepted by my eye Doctor. So I pay them at time of service and submit a claim. Unfortunately, my insurance will only make the check payable to the Doctor, so then the Doctor has to write me a check and refund it to me.

 

[Starport Seven-Five]

There are many slices of this dysfunctional pizza. I think we all personally know cases where bills rung up in the hundred thousands and covered by insurance. I know many cases where a family had bills over a million and still not done yet. I could count a dozen right off the top of my head on the prior.

The worst is seeing the portions of the bills that get discounted just because you have insurance. Why is a hospital allowed to bill me 4k for a procedure and then accept 1k as the payment from insurance? You know if you are uninsured they're going to send you to collections for the 4k amount...

How are these costs so high when our collective health is not really any better for it?

Lots of tails to this. Administrative overhead, insurance companies that provide zero care but increase the cost of our health care, malpractice insurance, very little regulation of what the pharmaceutical industry can charge, etc.

I spent 3 years working in the healthcare field (Engineering). When you first start they give you this speech about how you're doing noble work and saving lives. Then a week later you see them prioritizing projects based on profit margin or raise prices on life saving drugs and the shine wears off.

How can those costs be managed back into reality without regulations or crashing the stock market and retirement funds?

Follow the model of every other western nation? There will be growing pains for sure but I would think reducing our per capita healthcare expenditures by half would more than offset any economic harm done to the medical industry. A lot of the jobs currently are just pushing paper and provide zero value to the end patient.

 

[backformore]

That is laughable... They are not required by law to treat anyone except in an emergent situation and even then they only have to stabilize.

Doctors aren't required by LAW to treat anyone, sure. But the code of ethics dictates that once a doctor sees a patient for a particular issue, they are supposed to follow up and continue providing care until the issue is resolved.

 

[tvguy]

Doctors aren't required by LAW to treat anyone, sure. But the code of ethics dictates that once a doctor sees a patient for a particular issue, they are supposed to follow up and continue providing care until the issue is resolved.

Yes, if you go to an emergency room the Doctor has to treat you in
almost all instances.

 

[Southernmiss]

Yes, if you go to an emergency room the Doctor has to treat you in
almost all instances.

Yep.

Many houseless people and drug addicts come in, get out of the elements, patched up and back on their way. Some are regulars the staff know by name and complaints.

 

[lanejudy]

even kicked some people off (like retired spouses)

Furthermore now retirees that had good employer based healthcare are required to go on Medicare

DH is retired and he's on my employer-sponsored family coverage and has been for several years. My employer dropped retiree healthcare back in the early 2000's (and I know of several employers that dropped it before then) - long before ACA came into play. It was solidly an employer cost-savings decision.

The 2 situations quoted above were EMPLOYER choices, nobody forced them. It may have been due to multiple circumstances and I agree that health insurance prices are outrageous, but dropping such coverages were not dictated by anyone other than the employer's own decisions.

 

[tvguy]

DH is retired and he's on my employer-sponsored family coverage and has been for several years. My employer dropped retiree healthcare back in the early 2000's (and I know of several employers that dropped it before then) - long before ACA came into play. It was solidly an employer cost-savings decision.

The 2 situations quoted above were EMPLOYER choices, nobody forced them. It may have been due to multiple circumstances and I agree that health insurance prices are outrageous, but dropping such coverages were not dictated by anyone other than the employer's own decisions.

I always think of retiree healthcare benefits are something that is common in public sector jobs, and rare in the private sector. Most jobs with the State of California, you are vested in low or no cost health benefits for life if you work in the job for at least 5 years. A lot of people I worked with in their mid to late 50's get a state job just for that benefit.
I worked for 9 different corporate owners in 42 years and none offered retiree benefits, and one REQUIRED current employees to go on Medicare when they reached 65.

 

[tvguy]

Yep.

Many houseless people and drug addicts come in, get out of the elements, patched up and back on their way. Some are regulars the staff know by name and complaints.

Yep. "Frequent flyers" as they are called by first responders and emergency room workers.

 

[tarheelmjfan]

Yep.

Many houseless people and drug addicts come in, get out of the elements, patched up and back on their way. Some are regulars the staff know by name and complaints.

That only works for people who have nothing to lose. For the rest of us, frequent emergency room visits could bankrupt someone without insurance. The hospital will come after the money.

 

[tvguy]

That only works for people who have nothing to lose. For the rest of us, frequent emergency room visits could bankrupt someone without insurance. The hospital will come after the money.

Yes, but these days some consider filing bankruptcy a normal part of life. And they do it more than once.

 

[tarheelmjfan]

Yes, but these days some consider filing bankruptcy a normal part of life. And they do it more than once.

I don't think that's true for the vast majority of people.

 

[tvguy]

I don't think that's true for the vast majority of people.

Probably not, but there I times that I seriously question that. Especially the folks who have filed two and three times. The get their debt discharged, then go out an buy another boat, an RV, a diesel pickup to tow the RV, a Jeep for offroading, and when they can't pay for it, they file bankruptcy again. That was my former next door neighbor. But the third time, he was furious he couldn't pick and choose what debt he could discharge. He wanted to get the mortgage discharged and keep the boat, RV, diesel pickup and Jeep. Then he was told he couldn't pick and choose and then the Bankruptcy Judge looked at his wife's income and said, "looking at your wife's income, you CAN afford to make those payments" They finally did a short sale on their house and kept the toys and started renting.

 

[mi*vida*loca]

Probably not, but there I times that I seriously question that. Especially the folks who have filed two and three times. The get their debt discharged, then go out an buy another boat, an RV, a diesel pickup to tow the RV, a Jeep for offroading, and when they can't pay for it, they file bankruptcy again. That was my former next door neighbor. But the third time, he was furious he couldn't pick and choose what debt he could discharge. He wanted to get the mortgage discharged and keep the boat, RV, diesel pickup and Jeep. Then he was told he couldn't pick and choose and then the Bankruptcy Judge looked at his wife's income and said, "looking at your wife's income, you CAN afford to make those payments" They finally did a short sale on their house and kept the toys and started renting.

The number one reason people file bankruptcy is due to medical bills. Followed up by job loss, reduced income and divorce. Not because they want fancy new toys.

I read once that the government “likes” bankruptcy because it helps the economy. If someone is straddled in debt and unable to buy anything then they aren’t stimulating the economy. Free them of their debt and they can start spending again. There’s a reason it’s legal and at times encouraged.

 

[tvguy]

The number one reason people file bankruptcy is due to medical bills. Followed up by job loss, reduced income and divorce. Not because they want fancy new toys.

I read once that the government “likes” bankruptcy because it helps the economy. If someone is straddled in debt and unable to buy anything then they aren’t stimulating the economy. Free them of their debt and they can start spending again. There’s a reason it’s legal and at times encouraged.

Actually, no, Job Loss is number one. And everything else really takes a distance back seat since if you have no income to pay any bills.
But with the case of my former neighbor, job loss was the reason he sought bankruptcy protection the third time. His previous two bankruptcy filings as a single man were the reason he and his income were NOT on any of the credit accounts he was trying to discharge with his wife. She still had her job and she had the income to cover all the bills.

 

[mi*vida*loca]

Actually, no, Job Loss is number one. And everything else really takes a distance back seat since if you have no income to pay any bills.
But with the case of my former neighbor, job loss was the reason he sought bankruptcy protection the third time. His previous two bankruptcy filings as a single man were the reason he and his income were NOT on any of the credit accounts he was trying to discharge with his wife. She still had her job and she had the income to cover all the bills.

Some sites I checked said medical debt. Some say job loss. Depending on the year. Either way most aren’t just racking up debt for fun then filing but of course there will always be some that work the system for their own benefit. Seems that your neighbor got called out by the judge and I’m sure it’s happened to others that abuse the system.

 

[tvguy]

Some sites I checked said medical debt. Some say job loss. Depending on the year. Either way most aren’t just racking up debt for fun then filing but of course there will always be some that work the system for their own benefit. Seems that your neighbor got called out by the judge and I’m sure it’s happened to others that abuse the system.

Yeah, and usually if you try, a payment plan can be worked out with medical providers. I thing some people abuse the system, and others just don't want to do the work involved in getting their debt paid off.

 

[Dznypal]

I had an ob/gyn I really liked but when we had to change insurance she wasnt in the new network. We even offered to pay out of pocket. Since it’s just for the once a year deal. It just so happened that at one of my oncology app we were telling her about that and she said I could keep coming to see her for the yearly checks. Not as a cancer patient since I’m in the clear for that but just the checks. I was so happy cause I feel so comfortable with her

 

[Marrila]

Yeah, and usually if you try, a payment plan can be worked out with medical providers. I thing some people abuse the system, and others just don't want to do the work involved in getting their debt paid off.

I hope, when I'm senior enough to qualify for Medicare, I'm thankful and humble.
It's a program of great privilege. Meanwhile many families struggle to make hard choices abou purchasing medical care. It seems only right to respectfully remember their challenges.

 

[tvguy]

I hope, when I'm senior enough to qualify for Medicare, I'm thankful and humble.
It's a program of great privilege. Meanwhile many families struggle to make hard choices abou purchasing medical care. It seems only right to respectfully remember their challenges.

Not a privilege. I paid for that Medicare coverage with deductions from every paycheck I got for 50 years, and I pay $327.53 in Part B, Part D and Part G premiums every month.