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Recognized Social Butterfly
Posts: 836
Registered: ‎09-03-2011

Re: Insurance companies put a time limit on a doctor's appointment

Message 1 of 6 (487 Views)

GailL1 wrote:

ReTiReD51 wrote:

It's not your insurance company.

 

In 1992 Medicare adopted the “relative value unit” or “RVU” formula.  It created a standard for calculating doctor’s fees.

 

(Work RVU x Geographic Index + Practice Expenses RVU x Geographic Index + Liability Insurance RVU x Geographic Index) x Medicare Conversion Factor.

 

The idea behind a standardize formula to calculate fees was so Doctors fees didn’t vary much within geographical areas.

 

Based on this formula a typical primary care office visit is 1.3 RVU’s which translates to a 15 minute visit. This is the normal.


And now we are even going to get away from that and pay them for the total treatment of many therapies.  Currently, I believe, since this will be somewhat of a test, the doctors will have to volunteer to participate but If it is even relatively successful, it will become standard practice.

 

We do need to get away from fee-for-services everywhere that we can.


Are you referring to the “Doc Fix” legislation? Medicare doctors are reimbursed for the quality and not the quantity of care.

 

This newer method of payment is supposed to result in more collaboration and coordination of care for all but especially Medicare beneficiaries. And I think Healthcare providers are guarantee a small increase in reimbursement each year.

 

Already here in Ohio all the major hospitals are putting into place a health information exchange software called Epic.  Where the different hospitals/doctors’ offices share the health records of patients electronically. Epic will even share those records with a competitor in any of the 50 states. Given time I think we’ll see lower costs and better care for patients if all hospitals and doctors can access a patients records electronically anywhere in the country

Valued Social Butterfly
Posts: 8,603
Registered: ‎08-18-2008

Re: Insurance companies put a time limit on a doctor's appointment

Message 2 of 6 (508 Views)

ReTiReD51 wrote:

It's not your insurance company.

 

In 1992 Medicare adopted the “relative value unit” or “RVU” formula.  It created a standard for calculating doctor’s fees.

 

(Work RVU x Geographic Index + Practice Expenses RVU x Geographic Index + Liability Insurance RVU x Geographic Index) x Medicare Conversion Factor.

 

The idea behind a standardize formula to calculate fees was so Doctors fees didn’t vary much within geographical areas.

 

Based on this formula a typical primary care office visit is 1.3 RVU’s which translates to a 15 minute visit. This is the normal.


And now we are even going to get away from that and pay them for the total treatment of many therapies.  Currently, I believe, since this will be somewhat of a test, the doctors will have to volunteer to participate but If it is even relatively successful, it will become standard practice.

 

We do need to get away from fee-for-services everywhere that we can.

Recognized Social Butterfly
Posts: 836
Registered: ‎09-03-2011

Re: Insurance companies put a time limit on a doctor's appointment

Message 3 of 6 (528 Views)

It's not your insurance company.

 

In 1992 Medicare adopted the “relative value unit” or “RVU” formula.  It created a standard for calculating doctor’s fees.

 

(Work RVU x Geographic Index + Practice Expenses RVU x Geographic Index + Liability Insurance RVU x Geographic Index) x Medicare Conversion Factor.

 

The idea behind a standardize formula to calculate fees was so Doctors fees didn’t vary much within geographical areas.

 

Based on this formula a typical primary care office visit is 1.3 RVU’s which translates to a 15 minute visit. This is the normal.

Valued Social Butterfly
Posts: 8,603
Registered: ‎08-18-2008

Re: Insurance companies put a time limit on a doctor's appointment

[ Edited ]
Message 4 of 6 (539 Views)

@jp10113392

Your doctor is the one that controls the diagnostic/service codes which are sent to your insurance company - public or private.  He can code your visit as minimal, intermediate or extensive and each carries a different amount of payment from the public or private insurer.  However, the other things which he does has to correlate with this coding.

 

As retiredtraveler mentioned, there are concierge type doctors which will, for a monthly or yearly fee, will give you added time and services in this agreement.  In fact, if there is a need -'will even make house calls. 

 

What at type of insurance are you talking about - ?  Private insurance, Original Medicare, Medicare Advantage? 

Trusted Social Butterfly
Posts: 7,094
Registered: ‎02-14-2008

Re: Insurance companies put a time limit on a doctor's appointment

[ Edited ]
Message 5 of 6 (551 Views)

"...The time and the payments to the doctors should not be squeezed to the point that neither they nor their patients are benefited....".

 

Agreed. But like all the other issues related to healthcare, I don't see how it can change. It is about the money, but it's also about the doc's income, not simply the insurance companies I think a great many people fail to understand the enormous, financial, overhead a doctor's office has. All the staff such as receptionist, medical biller, CNA's have to be paid out of the 'profit'. And the rent/lease cost is not waived.

   You do have the ability, if available in your area, to get boutique care. It could cost you thousands per month, or may only hundreds plus $500 a visit. Fees are all over the place.

   The other cost many don't realize is student loans. I have a relative that has a specialty, but has almost $500,000 in loans to get all that schooling. He'll never get these loans paid unless he makes in excess of $100,000 a year and lives very frugally.

 

   I have no answers. Free tuition for all medical students?       


Just think. The world was built by the lowest bidder.
Info Seeker
Posts: 1
Registered: ‎06-29-2014

Insurance companies put a time limit on a doctor's appointment

Message 6 of 6 (591 Views)

I am concerned about too short medical visits. Our latest insurance update says that 'most appointments should be less than 15 minutes.' There are so many problems with limiting the time charge of a physician with a patient. Sure, a visit for an ear infection or a cold may be easily handled in that time. In my experience, the actual time with the MD might easily take longer than 15 minutes on an annual exam or when a new set of symptoms are being diagnosed, especially as we have more health issues to deal with while aging. So are the insurance companies indicating that we should go to the MD 6 times to go over the issues for 6 office appointments of 15 minutes? Or is it more efficient to cover the symptoms and/or questions, interpret lab and examination data, and give clear guidance as to treatment to the patient? Here are two specific examples which I've had. Our newly licensed general practitioner (Internal Medicine Board Certified) was very good and got better each year he practiced in helping his patients. In the exam on the 3rd year he told my husband and myself that he was leaving that practice to work at drug-patient medical facilities (which he was a partial owner of) because the practice owned by a large hospital corporation would allow him only 15 minutes for an annual exam. The second example occurred while visiting a dermatologist consulted for a 2nd opinion. For over 18 months I suffered the extreme pain of dry, itchy skin. The new dermatologist diagnosed the cause as neuropathy (not just dryness) and had only 15 minutes to diagnose and explain the treatment regime. It required a very complicated approach to determining by trial the correct dosage of a medication. Luckily it only resulted (to my knowledge) in several weeks of overdosing! Many of us of advanced age have a complicated medical history. I think it is very important to have sufficient discussion (and time) to diagnose, teach the treatment, and determine future needs. The time and the payments to the doctors should not be squeezed to the point that neither they nor their patients are benefited. It appears to me to be an attempt to increase corporate profits without regard to whether the outcomes are positive.