Re: FW: Fee Schedules & Deductible Plans

[Guest guest]

,

Very interesting indeed. Personally I find it of even more interest because we too practice and live in the area of influence of the same exact BC/BS group Excellus who are the majority market controller here in CNY... I love this kind of info. It still amazes me that the carriers are completely allowed access to info like this from other carriers as we as from us providers and are allowed to share such info in a collusion like manner, but us pimple sized private practices are such a threat to them and the public that we are not allowed to share the same kind of data in like kind....

BTW, what is the PM group you are a member of and how does one get involved or join??? Ya know this is an interesting twist on the same old problem... What if we as "Consumers" of medicine were to report back to some centralized home base our experiences as consumers, not doctors, and asked our patients to voluntarily do likewise, would the sharing of such information, as consumer generated for informational sakes, to inform our patients as to the fees being charged, paid, allowed at various practices and groups from all the different carriers, if this would then be allowed? It is consumers voluntarily sharing their own data for the better consumer experience of all???? Thoughts, Ideas, problems suggestions, other tangented brain storms???

To: Sent: Mon, January 10, 2011 2:35:53 PMSubject: FW: Fee Schedules & Deductible Plans

I’m forwarding an e-mail that came through on an office managers listserve I am on (because those of us who are solo-solo are the office mgrs too! I do have an assistant who works for me 12 hrs a week or so, but she isn’t yet in a managerial role); it was written by another office manager, but from his perspective as a patient. Interesting perspective on the higher fees that larger hospital-owned groups are able to negotiate with insurers; to be honest, I hadn’t thought how those negotiations would affect patients payment, but of course it does in these high deductible plans. Hoping this whole system self-combusts in the next 5-10 yrs and we’re left with a reasonable and transparent system of health care financing (which I feel would best be done in a single-payer system, but don’t want to engage in heated political debate because I know there are people on this list who disagree

and feel strongly so).

Take care,

-

Queenan, MD

Queenan Family Medicine and Maternity Care

"Mindful Medicine for whole body, mind, and spirit"

1501 East Ave, Ste 211

Rochester, NY 14610

(phone and fax)

queenan@...

www.queenanfamilymedicine.com

This email transmission may contain protected and privileged, highlyconfidential medical, Personal and Health Information (PHI) and/or legalinformation. The information is intended only for the use of the individualor entity named above.If you are not the intended recipient of this material, you may not use,publish, discuss, disseminate or otherwise distribute it. If you are not theintended recipient, or if you have received this transmission in error,please notify the sender immediately and confidentially destroy theinformation that email in error

Sent: Monday, January 10, 2011 11:35 AMTo: Office managers MCMS ListServSubject: Fee Schedules & Deductible Plans

Interesting scenario recently:

I recently went to my doctor (who is employed by the largest hospital in town).

A family member went to their doctor (who is in private practice).

We both have the exact same health insurance.

We both live close to each other.

Our doctors are close to each other.

We both were billed for the exact same CPT code.

We both have the exact same high deductible insurance plans.

We happened to talk about it and compared notes.

I was charged 13.5% more for the exact same CPT code than my other family member.

The only difference was the "allowed amount" from Excellus.

This extra 13.5% that I am paying makes a very big difference in using up my HSA funds.

Why is there such a huge difference in what I have to pay versus my family member?

How can patients find out in advance about such huge differences in "allowed amounts"?

y

[Guest guest]

, Wow. Thanks for sharing this information., Very interesting thought : Patients/ consumers sharing fee, charges and payment data. increase transparency, what a concept. If the patients disclose the fees they were charged, it seems that this could not be called collusion by the medical practices. The insurance industry clearly benefits from the mystery that surrounds how much medical care actually costs. If fees and healthcare costs were obvious to all, then it seems likely that people would learn not only of this peculiar fee/payment discrepancy, but also just how much this huge insurance industry itself is costing medical consumers. In terms of implementation:• The entity collecting this information could not be connected with physicians and nurses in any way.• I would not trust the AMA to conduct this data collection.• Important considerations would include protection of the data from manipulation by the insurance industry itself or undo influence by doctors, nurses and hospitals. The amount of money at stake is high. The insurance industry certainly has the money and motivation to highjack a data bank of fees. , Very interesting indeed. Personally I find it of even more interest because we too practice and live in the area of influence of the same exact BC/BS group Excellus who are the majority market controller here in CNY... I love this kind of info. It still amazes me that the carriers are completely allowed access to info like this from other carriers as we as from us providers and are allowed to share such info in a collusion like manner, but us pimple sized private practices are such a threat to them and the public that we are not allowed to share the same kind of data in like kind.... BTW, what is the PM group you are a member of and how does one get involved or join??? Ya know this is an interesting twist on the same old problem... What if we as "Consumers" of medicine were to report back to some centralized home base our experiences as consumers, not doctors, and asked our patients to voluntarily do likewise, would the sharing of such information, as consumer generated for informational sakes, to inform our patients as to the fees being charged, paid, allowed at various practices and groups from all the different carriers, if this would then be allowed? It is consumers voluntarily sharing their own data for the better consumer experience of all???? Thoughts, Ideas, problems suggestions, other tangented brain storms??? To: Sent: Mon, January 10, 2011 2:35:53 PMSubject: FW: Fee Schedules & Deductible Plans I’m forwarding an e-mail that came through on an office managers listserve I am on (because those of us who are solo-solo are the office mgrs too! I do have an assistant who works for me 12 hrs a week or so, but she isn’t yet in a managerial role); it was written by another office manager, but from his perspective as a patient. Interesting perspective on the higher fees that larger hospital-owned groups are able to negotiate with insurers; to be honest, I hadn’t thought how those negotiations would affect patients payment, but of course it does in these high deductible plans. Hoping this whole system self-combusts in the next 5-10 yrs and we’re left with a reasonable and transparent system of health care financing (which I feel would best be done in a single-payer system, but don’t want to engage in heated political debate because I know there are people on this list who disagree and feel strongly so). Take care,- Queenan, MDQueenan Family Medicine and Maternity Care"Mindful Medicine for whole body, mind, and spirit"1501 East Ave, Ste 211Rochester, NY 14610 (phone and fax)queenan@...www.queenanfamilymedicine.comThis email transmission may contain protected and privileged, highlyconfidential medical, Personal and Health Information (PHI) and/or legalinformation. The information is intended only for the use of the individualor entity named above.If you are not the intended recipient of this material, you may not use,publish, discuss, disseminate or otherwise distribute it. If you are not theintended recipient, or if you have received this transmission in error,please notify the sender immediately and confidentially destroy theinformation that email in errorSent: Monday, January 10, 2011 11:35 AMTo: Office managers MCMS ListServSubject: Fee Schedules & Deductible Plans Interesting scenario recently: I recently went to my doctor (who is employed by the largest hospital in town). A family member went to their doctor (who is in private practice). We both have the exact same health insurance.We both live close to each other.Our doctors are close to each other.We both were billed for the exact same CPT code.We both have the exact same high deductible insurance plans.We happened to talk about it and compared notes. I was charged 13.5% more for the exact same CPT code than my other family member.The only difference was the "allowed amount" from Excellus. This extra 13.5% that I am paying makes a very big difference in using up my HSA funds. Why is there such a huge difference in what I have to pay versus my family member? How can patients find out in advance about such huge differences in "allowed amounts"? y

[Guest guest]

, Wow. Thanks for sharing this information., Very interesting thought : Patients/ consumers sharing fee, charges and payment data. increase transparency, what a concept. If the patients disclose the fees they were charged, it seems that this could not be called collusion by the medical practices. The insurance industry clearly benefits from the mystery that surrounds how much medical care actually costs. If fees and healthcare costs were obvious to all, then it seems likely that people would learn not only of this peculiar fee/payment discrepancy, but also just how much this huge insurance industry itself is costing medical consumers. In terms of implementation:• The entity collecting this information could not be connected with physicians and nurses in any way.• I would not trust the AMA to conduct this data collection.• Important considerations would include protection of the data from manipulation by the insurance industry itself or undo influence by doctors, nurses and hospitals. The amount of money at stake is high. The insurance industry certainly has the money and motivation to highjack a data bank of fees. , Very interesting indeed. Personally I find it of even more interest because we too practice and live in the area of influence of the same exact BC/BS group Excellus who are the majority market controller here in CNY... I love this kind of info. It still amazes me that the carriers are completely allowed access to info like this from other carriers as we as from us providers and are allowed to share such info in a collusion like manner, but us pimple sized private practices are such a threat to them and the public that we are not allowed to share the same kind of data in like kind.... BTW, what is the PM group you are a member of and how does one get involved or join??? Ya know this is an interesting twist on the same old problem... What if we as "Consumers" of medicine were to report back to some centralized home base our experiences as consumers, not doctors, and asked our patients to voluntarily do likewise, would the sharing of such information, as consumer generated for informational sakes, to inform our patients as to the fees being charged, paid, allowed at various practices and groups from all the different carriers, if this would then be allowed? It is consumers voluntarily sharing their own data for the better consumer experience of all???? Thoughts, Ideas, problems suggestions, other tangented brain storms??? To: Sent: Mon, January 10, 2011 2:35:53 PMSubject: FW: Fee Schedules & Deductible Plans I’m forwarding an e-mail that came through on an office managers listserve I am on (because those of us who are solo-solo are the office mgrs too! I do have an assistant who works for me 12 hrs a week or so, but she isn’t yet in a managerial role); it was written by another office manager, but from his perspective as a patient. Interesting perspective on the higher fees that larger hospital-owned groups are able to negotiate with insurers; to be honest, I hadn’t thought how those negotiations would affect patients payment, but of course it does in these high deductible plans. Hoping this whole system self-combusts in the next 5-10 yrs and we’re left with a reasonable and transparent system of health care financing (which I feel would best be done in a single-payer system, but don’t want to engage in heated political debate because I know there are people on this list who disagree and feel strongly so). Take care,- Queenan, MDQueenan Family Medicine and Maternity Care"Mindful Medicine for whole body, mind, and spirit"1501 East Ave, Ste 211Rochester, NY 14610 (phone and fax)queenan@...www.queenanfamilymedicine.comThis email transmission may contain protected and privileged, highlyconfidential medical, Personal and Health Information (PHI) and/or legalinformation. The information is intended only for the use of the individualor entity named above.If you are not the intended recipient of this material, you may not use,publish, discuss, disseminate or otherwise distribute it. If you are not theintended recipient, or if you have received this transmission in error,please notify the sender immediately and confidentially destroy theinformation that email in errorSent: Monday, January 10, 2011 11:35 AMTo: Office managers MCMS ListServSubject: Fee Schedules & Deductible Plans Interesting scenario recently: I recently went to my doctor (who is employed by the largest hospital in town). A family member went to their doctor (who is in private practice). We both have the exact same health insurance.We both live close to each other.Our doctors are close to each other.We both were billed for the exact same CPT code.We both have the exact same high deductible insurance plans.We happened to talk about it and compared notes. I was charged 13.5% more for the exact same CPT code than my other family member.The only difference was the "allowed amount" from Excellus. This extra 13.5% that I am paying makes a very big difference in using up my HSA funds. Why is there such a huge difference in what I have to pay versus my family member? How can patients find out in advance about such huge differences in "allowed amounts"? y

[Guest guest]

Thanks,

I have been a bit preoccuppied as of late with other problems and issues but the concept of starting such a database made up of consumers collected at a website and screened or controlled by someone like myself is very appealing. Then simply post what we have as we get and sort of confirm it somehow, perhaps by waiting to see double or triple confirmation like a newspaper would. Funny thing though, last time I remember with many of my personal EOB's there was NO Level or E & M code on the EOB, it was simply doctor's office services or something like that. I have been a bit bewildered by this for quite some time because we all know that there are quite a few different 'office visit" like codes including CPE's used to be Consults too, True Office Visits of various levels and the like...

But I need to think about this and try to work out the details a bit better. Anything we can do to help open up the process so doctors, patient consumers as well as employer consumers have a more detailed, open and honest insight as to what is going on with these bastards would be great!!!! Thoughts, suggestions, ideas???

To: Sent: Mon, January 10, 2011 5:24:41 PMSubject: Re: FW: Fee Schedules & Deductible Plans

, Wow. Thanks for sharing this information. , Very interesting thought : Patients/ consumers sharing fee, charges and payment data. increase transparency, what a concept. If the patients disclose the fees they were charged, it seems that this could not be called collusion by the medical practices.

The insurance industry clearly benefits from the mystery that surrounds how much medical care actually costs. If fees and healthcare costs were obvious to all, then it seems likely that people would learn not only of this peculiar fee/payment discrepancy, but also just how much this huge insurance industry itself is costing medical consumers.

In terms of implementation:

• The entity collecting this information could not be connected with physicians and nurses in any way.

• I would not trust the AMA to conduct this data collection.

• Important considerations would include protection of the data from manipulation by the insurance industry itself or undo influence by doctors, nurses and hospitals. The amount of money at stake is high. The insurance industry certainly has the money and motivation to highjack a data bank of fees.

,

Very interesting indeed. Personally I find it of even more interest because we too practice and live in the area of influence of the same exact BC/BS group Excellus who are the majority market controller here in CNY... I love this kind of info. It still amazes me that the carriers are completely allowed access to info like this from other carriers as we as from us providers and are allowed to share such info in a collusion like manner, but us pimple sized private practices are such a threat to them and the public that we are not allowed to share the same kind of data in like kind....

BTW, what is the PM group you are a member of and how does one get involved or join??? Ya know this is an interesting twist on the same old problem... What if we as "Consumers" of medicine were to report back to some centralized home base our experiences as consumers, not doctors, and asked our patients to voluntarily do likewise, would the sharing of such information, as consumer generated for informational sakes, to inform our patients as to the fees being charged, paid, allowed at various practices and groups from all the different carriers, if this would then be allowed? It is consumers voluntarily sharing their own data for the better consumer experience of all???? Thoughts, Ideas, problems suggestions, other tangented brain storms???

To: Sent: Mon, January 10, 2011 2:35:53 PMSubject: FW: Fee Schedules & Deductible Plans

I’m forwarding an e-mail that came through on an office managers listserve I am on (because those of us who are solo-solo are the office mgrs too! I do have an assistant who works for me 12 hrs a week or so, but she isn’t yet in a managerial role); it was written by another office manager, but from his perspective as a patient. Interesting perspective on the higher fees that larger hospital-owned groups are able to negotiate with insurers; to be honest, I hadn’t thought how those negotiations would affect patients payment, but of course it does in these high deductible plans. Hoping this whole system self-combusts in the next 5-10 yrs and we’re left with a reasonable and transparent system of health care financing (which I feel would best be done in a single-payer system, but don’t want to engage in heated political debate because I know there are people on this list who

disagree and feel strongly so).

Take care,

-

Queenan, MD

Queenan Family Medicine and Maternity Care

"Mindful Medicine for whole body, mind, and spirit"

1501 East Ave, Ste 211

Rochester, NY 14610

(phone and fax)

queenan@...

www.queenanfamilymedicine.com

This email transmission may contain protected and privileged, highlyconfidential medical, Personal and Health Information (PHI) and/or legalinformation. The information is intended only for the use of the individualor entity named above.If you are not the intended recipient of this material, you may not use,publish, discuss, disseminate or otherwise distribute it. If you are not theintended recipient, or if you have received this transmission in error,please notify the sender immediately and confidentially destroy theinformation that email in error

Sent: Monday, January 10, 2011 11:35 AMTo: Office managers MCMS ListServSubject: Fee Schedules & Deductible Plans

Interesting scenario recently:

I recently went to my doctor (who is employed by the largest hospital in town).

A family member went to their doctor (who is in private practice).

We both have the exact same health insurance.

We both live close to each other.

Our doctors are close to each other.

We both were billed for the exact same CPT code.

We both have the exact same high deductible insurance plans.

We happened to talk about it and compared notes.

I was charged 13.5% more for the exact same CPT code than my other family member.

The only difference was the "allowed amount" from Excellus.

This extra 13.5% that I am paying makes a very big difference in using up my HSA funds.

Why is there such a huge difference in what I have to pay versus my family member?

How can patients find out in advance about such huge differences in "allowed amounts"?

y

[Guest guest]

Thanks,

I have been a bit preoccuppied as of late with other problems and issues but the concept of starting such a database made up of consumers collected at a website and screened or controlled by someone like myself is very appealing. Then simply post what we have as we get and sort of confirm it somehow, perhaps by waiting to see double or triple confirmation like a newspaper would. Funny thing though, last time I remember with many of my personal EOB's there was NO Level or E & M code on the EOB, it was simply doctor's office services or something like that. I have been a bit bewildered by this for quite some time because we all know that there are quite a few different 'office visit" like codes including CPE's used to be Consults too, True Office Visits of various levels and the like...

But I need to think about this and try to work out the details a bit better. Anything we can do to help open up the process so doctors, patient consumers as well as employer consumers have a more detailed, open and honest insight as to what is going on with these bastards would be great!!!! Thoughts, suggestions, ideas???

To: Sent: Mon, January 10, 2011 5:24:41 PMSubject: Re: FW: Fee Schedules & Deductible Plans

, Wow. Thanks for sharing this information. , Very interesting thought : Patients/ consumers sharing fee, charges and payment data. increase transparency, what a concept. If the patients disclose the fees they were charged, it seems that this could not be called collusion by the medical practices.

The insurance industry clearly benefits from the mystery that surrounds how much medical care actually costs. If fees and healthcare costs were obvious to all, then it seems likely that people would learn not only of this peculiar fee/payment discrepancy, but also just how much this huge insurance industry itself is costing medical consumers.

In terms of implementation:

• The entity collecting this information could not be connected with physicians and nurses in any way.

• I would not trust the AMA to conduct this data collection.

• Important considerations would include protection of the data from manipulation by the insurance industry itself or undo influence by doctors, nurses and hospitals. The amount of money at stake is high. The insurance industry certainly has the money and motivation to highjack a data bank of fees.

,

Very interesting indeed. Personally I find it of even more interest because we too practice and live in the area of influence of the same exact BC/BS group Excellus who are the majority market controller here in CNY... I love this kind of info. It still amazes me that the carriers are completely allowed access to info like this from other carriers as we as from us providers and are allowed to share such info in a collusion like manner, but us pimple sized private practices are such a threat to them and the public that we are not allowed to share the same kind of data in like kind....

BTW, what is the PM group you are a member of and how does one get involved or join??? Ya know this is an interesting twist on the same old problem... What if we as "Consumers" of medicine were to report back to some centralized home base our experiences as consumers, not doctors, and asked our patients to voluntarily do likewise, would the sharing of such information, as consumer generated for informational sakes, to inform our patients as to the fees being charged, paid, allowed at various practices and groups from all the different carriers, if this would then be allowed? It is consumers voluntarily sharing their own data for the better consumer experience of all???? Thoughts, Ideas, problems suggestions, other tangented brain storms???

To: Sent: Mon, January 10, 2011 2:35:53 PMSubject: FW: Fee Schedules & Deductible Plans

I’m forwarding an e-mail that came through on an office managers listserve I am on (because those of us who are solo-solo are the office mgrs too! I do have an assistant who works for me 12 hrs a week or so, but she isn’t yet in a managerial role); it was written by another office manager, but from his perspective as a patient. Interesting perspective on the higher fees that larger hospital-owned groups are able to negotiate with insurers; to be honest, I hadn’t thought how those negotiations would affect patients payment, but of course it does in these high deductible plans. Hoping this whole system self-combusts in the next 5-10 yrs and we’re left with a reasonable and transparent system of health care financing (which I feel would best be done in a single-payer system, but don’t want to engage in heated political debate because I know there are people on this list who

disagree and feel strongly so).

Take care,

-

Queenan, MD

Queenan Family Medicine and Maternity Care

"Mindful Medicine for whole body, mind, and spirit"

1501 East Ave, Ste 211

Rochester, NY 14610

(phone and fax)

queenan@...

www.queenanfamilymedicine.com

This email transmission may contain protected and privileged, highlyconfidential medical, Personal and Health Information (PHI) and/or legalinformation. The information is intended only for the use of the individualor entity named above.If you are not the intended recipient of this material, you may not use,publish, discuss, disseminate or otherwise distribute it. If you are not theintended recipient, or if you have received this transmission in error,please notify the sender immediately and confidentially destroy theinformation that email in error

Sent: Monday, January 10, 2011 11:35 AMTo: Office managers MCMS ListServSubject: Fee Schedules & Deductible Plans

Interesting scenario recently:

I recently went to my doctor (who is employed by the largest hospital in town).

A family member went to their doctor (who is in private practice).

We both have the exact same health insurance.

We both live close to each other.

Our doctors are close to each other.

We both were billed for the exact same CPT code.

We both have the exact same high deductible insurance plans.

We happened to talk about it and compared notes.

I was charged 13.5% more for the exact same CPT code than my other family member.

The only difference was the "allowed amount" from Excellus.

This extra 13.5% that I am paying makes a very big difference in using up my HSA funds.

Why is there such a huge difference in what I have to pay versus my family member?

How can patients find out in advance about such huge differences in "allowed amounts"?

y

[Guest guest]

I think the Happy Hospitalist ( see his blog ) had a survey up collecting this info a year or so ago....

 

Thanks,

    I have been a bit preoccuppied as of late with other problems and issues but the concept of starting such a database made up of consumers collected at a website and screened or controlled by someone like myself is very appealing. Then simply post what we have as we get and sort of confirm it somehow, perhaps by waiting to see double or triple confirmation like a newspaper would. Funny thing though, last time I remember with many of my personal EOB's there was NO Level or E & M code on the EOB, it was simply doctor's office services or something like that. I have been a bit bewildered by this for quite some time because we all know that there are quite a few different 'office visit " like codes including CPE's used to be Consults too, True Office Visits of various levels and the like...

 

    But I need to think about this and try to work out the details a bit better. Anything we can do to help open up the process so doctors, patient consumers as well as employer consumers have a more detailed, open and honest insight as to what is going on with these bastards would be great!!!! Thoughts, suggestions, ideas???

 

To:

Sent: Mon, January 10, 2011 5:24:41 PMSubject: Re: FW: Fee Schedules & Deductible Plans

 

, Wow.  Thanks for sharing this information. , Very interesting thought : Patients/ consumers sharing fee, charges and payment data.  increase transparency, what a concept.   If the patients disclose the fees they were charged, it seems that this could not be called collusion by the medical practices.  

The insurance industry clearly benefits from the mystery that surrounds how much medical care actually costs.  If fees and healthcare costs were obvious to all, then it seems likely that people would learn not only of this peculiar fee/payment discrepancy, but also just how much  this huge insurance industry itself is costing medical consumers.  

In terms of implementation:

•  The entity collecting this information could not be connected with physicians and nurses in any way.

•  I would not trust the AMA to conduct this data collection.

•  Important considerations would include protection of the data from  manipulation by the insurance industry itself or undo influence by doctors, nurses and hospitals.   The amount of money at stake is high.  The insurance industry certainly has the money and motivation to highjack a data bank of fees.  

 

,

    Very interesting indeed. Personally I find it of even more interest because we too practice and live in the area of influence of the same exact BC/BS group Excellus who are the majority market controller here in CNY... I love this kind of info. It still amazes me that the carriers are completely allowed access to info like this from other carriers as we as from us providers and are allowed to share such info in a collusion like manner, but us pimple sized private practices are such a threat to them and the public that we are not allowed to share the same kind of data in like kind....

 

    BTW, what is the PM group you are a member of and how does one get involved or join??? Ya know this is an interesting twist on the same old problem... What if we as " Consumers " of medicine were to report back to some centralized home base our experiences as consumers, not doctors, and asked our patients to voluntarily do likewise, would the sharing of such information, as consumer generated for informational sakes, to inform our patients as to the fees being charged, paid, allowed at various practices and groups from all the different carriers, if this would then be allowed? It is consumers voluntarily sharing their own data for the better consumer experience of all???? Thoughts, Ideas, problems suggestions, other tangented brain storms???

 

From:  Queenan To: 

Sent: Mon, January 10, 2011 2:35:53 PMSubject:  FW: Fee Schedules & Deductible Plans

 

I’m forwarding an e-mail that came through on an office managers listserve I am on (because those of us who are solo-solo are the office mgrs too! I do have an assistant who works for me 12 hrs a week or so, but she isn’t yet in a managerial role); it was written by another office manager, but from his perspective as a patient. Interesting perspective on the higher fees that larger hospital-owned groups are able to negotiate with insurers; to be honest, I hadn’t thought how those negotiations would affect patients payment, but of course it does in these high deductible plans. Hoping this whole system self-combusts in the next 5-10 yrs and we’re left with a reasonable and transparent system of health care financing (which I feel would best be done in a single-payer system, but don’t want to engage in heated political debate because I know there are people on this list who

disagree and feel strongly so).

 

Take care,

-

 

Queenan, MD

Queenan Family Medicine and Maternity Care

" Mindful Medicine for whole body, mind, and spirit "

1501 East Ave, Ste 211

Rochester, NY 14610

(phone and fax)

queenan@...

www.queenanfamilymedicine.com

This email transmission may contain protected and privileged, highlyconfidential medical, Personal and Health Information (PHI) and/or legalinformation. The information is intended only for the use of the individual

or entity named above.If you are not the intended recipient of this material, you may not use,publish, discuss, disseminate or otherwise distribute it. If you are not theintended recipient, or if you have received this transmission in error,

please notify the sender immediately and confidentially destroy theinformation that email in error

Sent: Monday, January 10, 2011 11:35 AMTo: Office managers MCMS ListServSubject: Fee Schedules & Deductible Plans

 

 

Interesting scenario recently:

 

I recently went to my doctor (who is employed by the largest hospital in town).

 

A family member went to their doctor (who is in private practice).

 

We both have the exact same health insurance.

We both live close to each other.

Our doctors are close to each other.

We both were billed for the exact same CPT code.

We both have the exact same high deductible insurance plans.

We happened to talk about it and compared notes.

 

I was charged 13.5% more for the exact same CPT code than my other family member.

The only difference was the " allowed amount " from Excellus.

 

This extra 13.5% that I am paying makes a very big difference in using up my HSA funds.

 

Why is there such a huge difference in what I have to pay versus my family member?

 

How can patients find out in advance about such huge differences in " allowed amounts " ?

 

 

 

 y

-- Sangeetha Murthy M.D7830 mont Mesa Blvd #287San Diego, CA 92111www.mypcponline.com