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  1. #11
    Join Date
    Jan 2006
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    38,867

    Default Re: Liability Trivia - Truck Driver Collides with Dangerously Low Hanging Wire

    Quote Quoting ebayuser
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    I am not. My whole point was if a professional did the same thing there would be all sorts of noise made. I even pointed out in a round about way that when doctors do it society calls it "concierge medicine" not medical care. I.e. we as a society do not tolerate this from professionals however it is considered okay when tradesman do it.



    Again most doctors are not contracted to come in. Even for the ones that are and are compensated differently you as the customer do NOT pay for the difference. I have no problem if an electrician company wants to compensate their employees differently for different types of call as long as the customer pays the same price.



    No I am holding electricians comparable to individual doctors. The hospital may be open 24 hours a day. Doctors are human and need somewhat regular hours.



    Then by definition you did NOT need emergency services. You visited an Emergency room and got immediate care from te ER doctor but the rest of it (i.e. the definitive treatment) was not an emergency.



    Trust me they are called in way more then you think. And it is not just being called in - the fact that someone called them, woke the up in the middle of the night, they reviewed the studies, and made a plan still constitutes them taking care of you (usually uncompensated until they see you in the morning and do a proper work up). And again addressing your jab on the ER doctor he is not charging you, the patient, more because you showed up in the middle of the night. The bill would have been the same if you showed up the next morning at 8 am.



    I agree with the first part of your statement. Most people have no clue how little they pay for doctors or how entitled they act (the patients).

    However, if the doctors charged you like your electrician does imagine the outrage, as you have clearly demonstrated. I am not sure why people find it ok and normal to pay their electrician 3x normal rates for after hour work but paying their doctor is wrong and health care should be a "right".

    As for the second part well at least its the same rate on Friday night before a holiday weekend as 9 am on Wed unlike the electrician .
    You missed the point and all you are attempting to do is to expand the conversation so you can hear yourself talk.

    The floor’s all yours. You go on and ramble your incorrect and meaningless crap
    btw; yes, the broken ankle did require emergency treatment. Failure to address the break could have resulted in the loss of the foot.

  2. #12
    Join Date
    Jan 2010
    Location
    New Jersey
    Posts
    3,666

    Default Re: Liability Trivia - Truck Driver Collides with Dangerously Low Hanging Wire

    Quote Quoting Brian57
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    I just had hand surgery and observed the rate between the surgical center and my doctor being $5,000/hr which I paid cash for because my surgeon did not accept my insurance. Those are rates that not even the best lawyer in the country would charge. Oh, and my surgeon does about 5-8 of those surgeries per day twice a week.

    What did you ask the electrician to do at 10:00pm, and, how did you estimate that he was charging three times his rate?
    I saw the bill for my hand surgeon when he performed surgery to repair carpal tunnel syndrome. He billed my insurance $28,000, the insurance company paid him $9,000 because he was in my network... Not a bad payday if you ask me...

  3. #13
    Join Date
    Apr 2018
    Location
    Long Beach, CA
    Posts
    236

    Default Re: Liability Trivia - Truck Driver Collides with Dangerously Low Hanging Wire

    Quote Quoting Who'sThatGuy
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    I saw the bill for my hand surgeon when he performed surgery to repair carpal tunnel syndrome. He billed my insurance $28,000, the insurance company paid him $9,000 because he was in my network... Not a bad payday if you ask me...
    My physical therapist just told me yesterday that carpal tunnel is an easy surgery that often only takes 10 minutes.

    Did you know that the difference between the $28K and $9K is written off as a loss. It is a way the non-profit hospitals use to hide profit. It is also used to mislead the policyholder to think that $28K is the going rate...when it is a total fabrication.

  4. #14
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    Jan 2010
    Location
    New Jersey
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    3,666

    Default Re: Liability Trivia - Truck Driver Collides with Dangerously Low Hanging Wire

    Quote Quoting Brian57
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    My physical therapist just told me yesterday that carpal tunnel is an easy surgery that often only takes 10 minutes.

    Did you know that the difference between the $28K and $9K is written off as a loss. It is a way the non-profit hospitals use to hide profit. It is also used to mislead the policyholder to think that $28K is the going rate...when it is a total fabrication.
    That's just sick if you ask me.

  5. #15
    Join Date
    Nov 2016
    Posts
    111

    Default Re: Liability Trivia - Truck Driver Collides with Dangerously Low Hanging Wire

    Quote Quoting Who'sThatGuy
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    I saw the bill for my hand surgeon when he performed surgery to repair carpal tunnel syndrome. He billed my insurance $28,000, the insurance company paid him $9,000 because he was in my network... Not a bad payday if you ask me...
    I don't work with too many hand surgeons but of the one's I have worked with NONE have ever billed $28K for carpal tunnel and certainly never been paid $9K just for the surgeons fee. I will post back after checking.

    Quote Quoting Brian57
    View Post
    My physical therapist just told me yesterday that carpal tunnel is an easy surgery that often only takes 10 minutes.
    The surgical portion usually does take 15-20 minutes. 10 is the upper limit of fast.

    Quote Quoting Brian57
    View Post
    Did you know that the difference between the $28K and $9K is written off as a loss. It is a way the non-profit hospitals use to hide profit. It is also used to mislead the policyholder to think that $28K is the going rate...when it is a total fabrication.
    That is pure BS. The difference can not be written off as a loss. Check the tax code. Furthermore, even actual losses can not be written off. I.E. You go to the doctor, he does surgery and you never pay. He can NOT write off that debt as a loss. If that was true no doctor would show income. Ever. Hospitals are a different matter. I am not sure what they can write off but they are not pertinent to the discussion of professionals charging more because it is a weekend/holiday like the tradesman do.

    Quote Quoting jk
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    yes, the broken ankle did require emergency treatment. Failure to address the break could have resulted in the loss of the foot.
    It required treatment which can be delivered the next day w/o causing injury. Hence it is NOT an emergency. An emergency, in the medical field, is something that can cause an immediate risk to life or limb - i.e. you cut through your hand with a saw and are bleeding like stink that is an emergency. You broke the bone in your arm, it is not sticking out of the skin, it can be set by the ER and you can have definitive tx in a few days.

    Quote Quoting Brian57
    View Post
    I'd be happy to tell you. The surgeon, who is at the top of his game as hand surgeons in the area, charged me $2,250 with a local or an additional $625 for a general. The surgical center charged $2,350. The surgery took about 50 minutes. I am certain a high paying platinum plan would be 'contracted' to pay nearly double that. He did at least 5 surgeries before mine and was out the door at 1:00pm. All surgeries paying more than my cash job.
    The $625 sounds right for cash pay depending on the length of the case. However, if it was only one hour that would be a bit excessive for anesthesia. The usual fee (at least in so cal) for one hour surgery is $400 - $500. That is what the anesthesiologist takes. Facility fees (the drugs, anesthesia machine, OR time) would be extra.

    Again, I don't deal with many hand surgeons but that seems very excessive unless it was a very complex procedure (e.g. he had to pull the nerve out of scar tissue). To give you an idea a blueshield PPO (80/20) plan pays about $400 for an Appendectomy to the surgeon (so $320 from insurance and $80 from patient). That fee BTW includes follow up visits for four weeks.

  6. #16
    Join Date
    Apr 2018
    Location
    Long Beach, CA
    Posts
    236

    Default Re: Liability Trivia - Truck Driver Collides with Dangerously Low Hanging Wire

    Quote Quoting ebayuser
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    That is pure BS. The difference can not be written off as a loss. Check the tax code. Furthermore, even actual losses can not be written off. I.E. You go to the doctor, he does surgery and you never pay. He can NOT write off that debt as a loss. If that was true no doctor would show income. Ever. Hospitals are a different matter. I am not sure what they can write off but they are not pertinent to the discussion of professionals charging more because it is a weekend/holiday like the tradesman do.
    I did not say private practice doctors can write off the difference, I said hospitals can. If you want to learn more about it, pull up Dr Keith Smith who founded and runs the 32Ksqft Surgical Center of Oklahoma. He goes into depth about our corrupt medical industry, speaking for hours on it. It is disgusting.

  7. #17
    Join Date
    Oct 2016
    Posts
    4,301

    Default Re: Liability Trivia - Truck Driver Collides with Dangerously Low Hanging Wire

    An Anesthesiologist with a different business model for surgical practice who obviously has every motivation to talk bad about other business models.

  8. #18
    Join Date
    Nov 2016
    Posts
    111

    Default Re: Liability Trivia - Truck Driver Collides with Dangerously Low Hanging Wire

    Quote Quoting Brian57
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    I did not say private practice doctors can write off the difference, I said hospitals can. If you want to learn more about it, pull up Dr Keith Smith who founded and runs the 32Ksqft Surgical Center of Oklahoma. He goes into depth about our corrupt medical industry, speaking for hours on it. It is disgusting.

    Right and as I said totally non-pertinent info to the discussion of tradesman charging more just because it is after hours.


    I also checked with a couple (yes as in two so no not a scientifically accurate sample) of hand surgeons. Neither has ever tried charging 28K for a carpal tunnel. They will push it and charge 7-9x medicare rates but of course they never get paid that. The usual ALLOWABLE re-imbursement from a PPO for carpal tunnel according to them is $600-$700. This includes the follow ups. Of that you have to spend even more time and money to try and collect the patients 20%.

    One did recall some guy who was charging crazy cash amounts and running a scam. However, he is currently in jail where he belongs. So if your insurance paid out 9K just to the surgeon for a simple carpal tunnel you really need to talk to your insurance company.

  9. #19
    Join Date
    Nov 2015
    Posts
    27

    Default Re: Liability Trivia - Truck Driver Collides with Dangerously Low Hanging Wire

    Quote Quoting Brian57
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    My physical therapist just told me yesterday that carpal tunnel is an easy surgery that often only takes 10 minutes.

    Did you know that the difference between the $28K and $9K is written off as a loss. It is a way the non-profit hospitals use to hide profit. It is also used to mislead the policyholder to think that $28K is the going rate...when it is a total fabrication.
    I'm not sure I want to assist in dragging this discussion further off the rails but...

    Uh, no. Hospitals and providers have contracted rates with insurers. This varies by contract and by insurer. (My personal carrier does have an online estimating tool, based on the area contracted rates.) The "losses" you speak of are typically booked as contracted adjustments, and are a normal part of the healthcare business. Revenue can be booked in a few different ways, but one of the more common ways is to book by contracted rate, not full rate. The full rate/contracted rate is not a way of "hiding profit." (And honestly, if you're stating that the hospital faces an $19K loss on a $28K surgery, where on earth is their profit?)

    There's a lot wrong with the healthcare industry, don't get me wrong, but as far as I know, non-profits don't use the difference between full rates and contracted rates to hide profit.

  10. #20
    Join Date
    Apr 2018
    Location
    Long Beach, CA
    Posts
    236

    Default Re: Liability Trivia - Truck Driver Collides with Dangerously Low Hanging Wire

    Quote Quoting ebayuser
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    Right and as I said totally non-pertinent info to the discussion of tradesman charging more just because it is after hours.
    Who knows if he charged 3x more? He never gave the scope of work or the amount he paid. Only that it was done at 10:00pm and he felt screwed.


    I also checked with a couple (yes as in two so no not a scientifically accurate sample) of hand surgeons. Neither has ever tried charging 28K for a carpal tunnel. They will push it and charge 7-9x medicare rates but of course they never get paid that. The usual ALLOWABLE re-imbursement from a PPO for carpal tunnel according to them is $600-$700. This includes the follow ups. Of that you have to spend even more time and money to try and collect the patients 20%.

    One did recall some guy who was charging crazy cash amounts and running a scam. However, he is currently in jail where he belongs. So if your insurance paid out 9K just to the surgeon for a simple carpal tunnel you really need to talk to your insurance company.
    Then where does that fake number come from? It is listed for deceptive reasons. But Dr Keith Smith will tell you why it is on a bill. There are more reasons than I stated.

    Quote Quoting PayrolGuy
    View Post
    An Anesthesiologist with a different business model for surgical practice who obviously has every motivation to talk bad about other business models.
    I don't care what Dr Keith Smith is. All that matters is if what he's saying is true.

    Listen to him, learn something, and report back. Is he FOS? If you say "yes," he has listed his credentials... then you must list yours.

    Quote Quoting Lexi44
    View Post
    I'm not sure I want to assist in dragging this discussion further off the rails but...

    Uh, no. Hospitals and providers have contracted rates with insurers. This varies by contract and by insurer. (My personal carrier does have an online estimating tool, based on the area contracted rates.) The "losses" you speak of are typically booked as contracted adjustments, and are a normal part of the healthcare business. Revenue can be booked in a few different ways, but one of the more common ways is to book by contracted rate, not full rate. The full rate/contracted rate is not a way of "hiding profit." (And honestly, if you're stating that the hospital faces an $19K loss on a $28K surgery, where on earth is their profit?)

    There's a lot wrong with the healthcare industry, don't get me wrong, but as far as I know, non-profits don't use the difference between full rates and contracted rates to hide profit.
    Did you know that well over half of our hospitals are non-profit and must show no profit. Well, how is that done when they do a $30K surgery and only have $5K-$10K of costs? When they charge $10K per bed per day?

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