Search found 963 matches

by toofache32
Sun Oct 15, 2017 10:53 pm
Forum: Personal Consumer Issues
Topic: Dental implants in Poland
Replies: 29
Views: 2321

Re: Dental implants in Poland

I've spent a considerable amount of my time and money on educating myself and training in dental implantology. It is true that just because you have your surgery done in the USA it may not be done any better than another country. There is a ton of legislation currently in the courts that will soon ...
by toofache32
Sun Oct 15, 2017 10:35 pm
Forum: Personal Consumer Issues
Topic: Dental implants in Poland
Replies: 29
Views: 2321

Re: Dental implants in Poland

I've spent a considerable amount of my time and money on educating myself and training in dental implantology. It is true that just because you have your surgery done in the USA it may not be done any better than another country. There is a ton of legislation currently in the courts that will soon ...
by toofache32
Sun Oct 15, 2017 4:29 pm
Forum: Personal Consumer Issues
Topic: Dental implants in Poland
Replies: 29
Views: 2321

Re: Dental implants in Poland

Most won't touch them since the last dentist to touch anything owns the problems. If true, this would be problematic even in the U.S. in cases where the practitioner had died or retired. Sorry I was referring to implants done overseas. There are so many "knock off" brands in other countries that ap...
by toofache32
Sun Oct 15, 2017 1:03 am
Forum: Personal Consumer Issues
Topic: Dental implants in Poland
Replies: 29
Views: 2321

Re: Dental implants in Poland

I have had many implants placed, all in the US. I would not be opposed to getting them done elsewhere, but IME they often require a fair amount of follow up, most often for bite issues. This is what I was thinking. Even implants that are "done right" need follow-up and maintenance. Problems develop...
by toofache32
Mon Oct 02, 2017 11:05 am
Forum: Personal Consumer Issues
Topic: What will happen if I refuse to pay a medical bill?
Replies: 125
Views: 7407

Re: What will happen if I refuse to pay a medical bill?

I suspect it may not be applicable for office visits, but I recall that you can get pre-authorization in writing from an insurance company for certain types of tests/procedures with certain providers. A pre-authorization does not guarantee anything and means nothing. At the bottom of every pre-auth...
by toofache32
Mon Oct 02, 2017 11:02 am
Forum: Personal Consumer Issues
Topic: What will happen if I refuse to pay a medical bill?
Replies: 125
Views: 7407

Re: What will happen if I refuse to pay a medical bill?

For son #1, one provider had been attempting to become a Cigna provider for 3 years. Called Cigna and they told me that they had enough of that specialty in my area so would not accept any new ones. I asked that they send me a list and they did. Out of the 10 they sent, 1 was dead, 1 was retired an...
by toofache32
Mon Oct 02, 2017 10:58 am
Forum: Personal Consumer Issues
Topic: What will happen if I refuse to pay a medical bill?
Replies: 125
Views: 7407

Re: What will happen if I refuse to pay a medical bill?

My wife had an insurance company try and refuse to pay a hospital bill that was pre-authorized, and required to be covered per the ACA. The bill was over $8,000 and it took months to finally get them to pay it. We had to pull in the US Department of Labor (DOL mediates and gets involved with ACA is...
by toofache32
Mon Oct 02, 2017 10:53 am
Forum: Personal Consumer Issues
Topic: The Expert's Dilemma - How can I know I'm getting a good physician without being one myself?
Replies: 125
Views: 8442

Re: The Expert's Dilemma - How can I know I'm getting a good physician without being one myself?

I would not say curiosity, but being thorough. When I teach residents I tell them the same thing it does not matter how smart or well read they are in their field. The BEST doctors are thorough. If a medical office is not thorough in processing insurance information is that a reflection on the phys...
by toofache32
Sun Oct 01, 2017 9:05 pm
Forum: Personal Consumer Issues
Topic: What will happen if I refuse to pay a medical bill?
Replies: 125
Views: 7407

Re: What will happen if I refuse to pay a medical bill?

In the end, it ALL depends if the office stated "Yes we are in network" or "Yes we accept your insurance". That difference is obviously a big one. Sorry, I've read through most of this thread and I'm honestly not sure which question I'm supposed to ask. In the past, I've checked the insurance compa...
by toofache32
Sun Oct 01, 2017 8:54 pm
Forum: Personal Consumer Issues
Topic: What will happen if I refuse to pay a medical bill?
Replies: 125
Views: 7407

Re: What will happen if I refuse to pay a medical bill?

In the end, it ALL depends if the office stated "Yes we are in network" or "Yes we accept your insurance". That difference is obviously a big one. Sorry, I've read through most of this thread and I'm honestly not sure which question I'm supposed to ask. In the past, I've checked the insurance compa...
by toofache32
Sun Oct 01, 2017 12:44 pm
Forum: Personal Consumer Issues
Topic: What will happen if I refuse to pay a medical bill?
Replies: 125
Views: 7407

Re: What will happen if I refuse to pay a medical bill?

Fascinating how these issues are creating new market niches. My practice is thriving in large part because none of my patients (literally zero) have these issues. They know exactly what everything costs up front and we never ask for more money later. There are never surprises. This is called being o...
by toofache32
Sat Sep 30, 2017 10:26 pm
Forum: Personal Consumer Issues
Topic: What will happen if I refuse to pay a medical bill?
Replies: 125
Views: 7407

Re: What will happen if I refuse to pay a medical bill?

I understand what you're all saying. Only the insurance company knows for sure. Not necessarily. See below. To repeat, one needs to ask the insurance company. You should ask BOTH. I am a doc who dropped Aetna almost a full year ago. I sent them my letter and have the certified mail receipt. They ar...
by toofache32
Tue Sep 26, 2017 10:57 pm
Forum: Personal Consumer Issues
Topic: Dental Insurance in Texas
Replies: 9
Views: 712

Re: Dental Insurance in Texas

There is no such thing as dental "insurance".

http://meadfamilydental.com/2011/12/lik ... rol-freak/
by toofache32
Tue Sep 26, 2017 10:31 pm
Forum: Personal Consumer Issues
Topic: The Expert's Dilemma - How can I know I'm getting a good physician without being one myself?
Replies: 125
Views: 8442

Re: The Expert's Dilemma - How can I know I'm getting a good physician without being one myself?

Bostondan gives great insight. As a surgeon, I would like to clarify the concept of "chief resident" as it is very different in surgical specialties compared to medical specialties. In some medical specialties, the chief resident is an administrative position where a resident who has otherwise finis...
by toofache32
Mon Sep 25, 2017 11:54 am
Forum: Personal Consumer Issues
Topic: The Expert's Dilemma - How can I know I'm getting a good physician without being one myself?
Replies: 125
Views: 8442

Re: The Expert's Dilemma - How can I know I'm getting a good physician without being one myself?

dm200 wrote:
Mon Sep 25, 2017 11:29 am
You are (or may be) restricted by your insurance coverage.
Not necessarily. Out of network surgeons usually take their patients to in-network hospitals for elective surgery. The hospital is the expensive part.
by toofache32
Sun Sep 24, 2017 11:45 pm
Forum: Personal Consumer Issues
Topic: The Expert's Dilemma - How can I know I'm getting a good physician without being one myself?
Replies: 125
Views: 8442

Re: The Expert's Dilemma - How can I know I'm getting a good physician without being one myself?

Don't forget to rule out the physicians who have had disciplinary actions against them and have been sued too many times. You can get this information from licensing boards and state court records. While intuitive on the surface, you have to view this from the perspective of the willingness of surg...
by toofache32
Wed Sep 20, 2017 11:28 am
Forum: Personal Consumer Issues
Topic: 1st medical bill, already overdue and threaten to send to collection
Replies: 44
Views: 3935

Re: 1st medical bill, already overdue and threaten to send to collection

Informed consent about bills is a huge problem, That's the only problem. Medicare subscribers must give their informed consent to pay more than their copay, it is federal law Question is why isn't that the law for ALL and not just medicare recipients? I don't go to the grocery store with no price t...
by toofache32
Wed Sep 20, 2017 10:48 am
Forum: Personal Consumer Issues
Topic: 1st medical bill, already overdue and threaten to send to collection
Replies: 44
Views: 3935

Re: 1st medical bill, already overdue and threaten to send to collection

Informed consent about bills is a huge problem, That's the only problem. Medicare subscribers must give their informed consent to pay more than their copay, it is federal law This is true. But this is not a solution, it's the source of a new problem. In choosing between seeing these patients for fr...
by toofache32
Wed Sep 20, 2017 10:09 am
Forum: Personal Consumer Issues
Topic: 1st medical bill, already overdue and threaten to send to collection
Replies: 44
Views: 3935

Re: 1st medical bill, already overdue and threaten to send to collection

Seems to me that people should be informed and give consent prior to being billed if their insurance company will not be paying , sounds like common sense to me. It's particularly unconscionable when they're charging $6k for an endoscopy which is a short procedure that likely only required deep sed...
by toofache32
Mon Sep 18, 2017 10:45 pm
Forum: Personal Consumer Issues
Topic: Dental Work
Replies: 15
Views: 1275

Re: Dental Work

I'm a dentist. If you're looking to find a GREAT dentist I would try calling your local dental specialty offices (Endodontists [root canal guys], Periodontists [gum guys], and oral surgeons [tooth pullers/surgeons]) and kindly ask their front desk people who good general dentists are in the area. T...
by toofache32
Mon Sep 18, 2017 10:40 pm
Forum: Personal Consumer Issues
Topic: Dental Work
Replies: 15
Views: 1275

Re: Dental Work

Based on your story my guess is work was done... Leakage occured probably from moisture contamination... it's only been 2 years so it's operator error not your error (Most likely but not absolute) ... and again you're in a clinic so rather than just replace the mess up they're gonna sell you more e...
by toofache32
Mon Sep 18, 2017 10:31 pm
Forum: Personal Consumer Issues
Topic: Dental Work
Replies: 15
Views: 1275

Re: Dental Work

Dental specialist here. I have not read all the responses. A few thoughts: 1. Dentists are on every corner. This is to your advantage. If you don't like yours, there are many others to choose from. Patients do not know what good dentistry is...they only know 2 things: did it hurt and does it look go...
by toofache32
Mon Sep 18, 2017 2:47 pm
Forum: Personal Consumer Issues
Topic: 1st medical bill, already overdue and threaten to send to collection
Replies: 44
Views: 3935

Re: 1st medical bill, already overdue and threaten to send to collection

Since I left the insurance world a couple years ago, I do not make more money. This is actually one of the most interesting aspects to me. It would be interesting (to me) to examine financial reports from "before" and "after" participating in the insurance network, and if the latter shows the same ...
by toofache32
Mon Sep 18, 2017 1:20 pm
Forum: Personal Consumer Issues
Topic: 1st medical bill, already overdue and threaten to send to collection
Replies: 44
Views: 3935

Re: 1st medical bill, already overdue and threaten to send to collection

Nobody ever asks why this doctor is not in-network... If your insurance paid market rates without having to fight for it , all the doctors would be signing up for it. If others in the "market" are accepting those insurance payments for the same services provided....then what makes you think that yo...
by toofache32
Sun Sep 17, 2017 10:11 pm
Forum: Personal Consumer Issues
Topic: 1st medical bill, already overdue and threaten to send to collection
Replies: 44
Views: 3935

Re: 1st medical bill, already overdue and threaten to send to collection

I can see the both side of the argument. I don't like the insurance companies as I have dealt with them with multiple issues whereby they refuse to pay for something they should pay. Then again is the provider side of things which I have absolutely no idea how much anything costs, if I knew it was ...
by toofache32
Sun Sep 17, 2017 4:35 pm
Forum: Personal Consumer Issues
Topic: A medical bill to argue?
Replies: 13
Views: 1420

Re: A medical bill to argue?

In my opinion, it makes sense to ask the receptionist what the charges will be. She represents the doctor (who doesn't have time to deal with insurance) and has access to the information that the insurance company will need and to the fee schedule. If she answered off the top of her head without ch...
by toofache32
Sun Sep 17, 2017 3:22 pm
Forum: Personal Consumer Issues
Topic: A medical bill to argue?
Replies: 13
Views: 1420

Re: A medical bill to argue?

In my opinion, it makes sense to ask the receptionist what the charges will be. She represents the doctor (who doesn't have time to deal with insurance) and has access to the information that the insurance company will need and to the fee schedule. If she answered off the top of her head without ch...
by toofache32
Sun Sep 17, 2017 2:49 pm
Forum: Personal Finance (Not Investing)
Topic: Medicare patients pay FAR MORE at 1300 rural Critical Access Hospitals
Replies: 55
Views: 3503

Re: Medicare patients pay FAR MORE at 1300 rural Critical Access Hospitals

Why would you get a colonoscopy at a hospital? That makes it more expensive than it needs to be, so the patient should pay those excessive charges. We get colonoscopies at the clinic part of our medical group. We are in and out in about 2 hours and it doesn't cost us anything. Medicare pays for all...
by toofache32
Sun Sep 17, 2017 1:45 pm
Forum: Personal Finance (Not Investing)
Topic: Medicare patients pay FAR MORE at 1300 rural Critical Access Hospitals
Replies: 55
Views: 3503

Re: Medicare patients pay FAR MORE at 1300 rural Critical Access Hospitals

Medicare also pays billions each year to train new doctors through residencies, that are mostly at large, university-affiliated medical centers. You never see this subsidy on the bill. https://economix.blogs.nytimes.com/2013/12/17/how-medicare-subsidizes-doctor-training/ You also never see the subs...
by toofache32
Sun Sep 17, 2017 1:45 pm
Forum: Personal Consumer Issues
Topic: A medical bill to argue?
Replies: 13
Views: 1420

Re: A medical bill to argue?

My Dentists can do this and is 100% accurate every time... Why did the billing systems for Dentists evolve to handle this but the medical billing systems for other health care areas have not? I suspect Dentists were tire of not getting paid and thus forced the issue. I suspect on the medical side m...
by toofache32
Sun Sep 17, 2017 3:01 am
Forum: Personal Consumer Issues
Topic: A medical bill to argue?
Replies: 13
Views: 1420

Re: A medical bill to argue?

Outrageous. Considering that many of the docs on this forum insist their profession is a business, what other business is there where one is quoted a price and the business itself charges several multiples of that quoted price for the service rendered without recourse for the consumer? Outrageous, ...
by toofache32
Sun Sep 17, 2017 2:54 am
Forum: Personal Finance (Not Investing)
Topic: Medicare patients pay FAR MORE at 1300 rural Critical Access Hospitals
Replies: 55
Views: 3503

Re: Medicare patients pay FAR MORE at 1300 rural Critical Access Hospitals

I'm confused. What is actionable here? Isn't this is what we all agreed to? The government is here to help us.
by toofache32
Fri Sep 15, 2017 9:45 am
Forum: Personal Consumer Issues
Topic: 1st medical bill, already overdue and threaten to send to collection
Replies: 44
Views: 3935

Re: 1st medical bill, already overdue and threaten to send to collection

Under no circumstances would I pay the bill. Third party medical providers have a distorted and extra-legal sense of entitlement, thinking they can bill charges not expressly authorized by the patient. You have more rights than they want you to believe. Assert them. (Your rights may include specifi...
by toofache32
Fri Sep 15, 2017 9:43 am
Forum: Personal Consumer Issues
Topic: 1st medical bill, already overdue and threaten to send to collection
Replies: 44
Views: 3935

Re: 1st medical bill, already overdue and threaten to send to collection

I read about these out of network provider threatening the patients and that forces insurance to pay the full amount to protect their customers. Our medical system seems to be a mess. I just checked my insurance claims online, they seem to be doing the same thing (although they missed one other cla...
by toofache32
Thu Sep 14, 2017 11:25 pm
Forum: Personal Consumer Issues
Topic: 1st medical bill, already overdue and threaten to send to collection
Replies: 44
Views: 3935

Re: 1st medical bill, already overdue and threaten to send to collection

As others have said, this is obviously an out of network situation. This would not be an issue if insurance companies played fair and paid reasonable rates without doctors having to fight so hard for valid claims. Nobody ever asks why this doctor is not in-network...If your insurance paid market rat...
by toofache32
Thu Sep 14, 2017 4:54 pm
Forum: Personal Consumer Issues
Topic: AMEX app
Replies: 16
Views: 764

Re: AMEX app

I use it for my business AmEx because it takes a photo of the receipt and I add a line like "dinner at Chicago conference". At the end of the year I can give it to my CPA all digital in a PDF or similar document.
by toofache32
Thu Sep 07, 2017 10:57 am
Forum: Personal Finance (Not Investing)
Topic: Opening a medical office...Can it still be done?
Replies: 29
Views: 5463

Re: Opening a medical office...Can it still be done?

I’m not a doctor, but I work for one of the giants in WPA. This market is totally different from rest of the country because of these competing giants. Both are doing everything to keep the care inside by starting very narrow products and limiting whom one can see. This will get worse for next 5 to...
by toofache32
Tue Sep 05, 2017 9:59 pm
Forum: Personal Consumer Issues
Topic: Name something you had to have and now you regret purchasing it?
Replies: 275
Views: 24277

Re: Name something you had to have and now you regret purchasing it?

My last bass boat... Blasphemy!! I've got a 2017 Ranger Z21 with Evinrude 250 G2 sitting outside right now. Had it 7 months and already have 80 hours on the motor. Dual power poles, three 12-inch Humminbird Helix graphs, MK Ulterra trolling motor, 3 sonar transducers. Saving money to upgrade to 3 L...
by toofache32
Tue Sep 05, 2017 9:47 pm
Forum: Personal Consumer Issues
Topic: Name something you had to have and now you regret purchasing it?
Replies: 275
Views: 24277

Re: Name something you had to have and now you regret purchasing it?

badbreath wrote:
Tue Sep 05, 2017 8:30 pm
My wife

I'm just kidding
You beat me to it!
by toofache32
Mon Sep 04, 2017 10:24 pm
Forum: Personal Finance (Not Investing)
Topic: Billing 99212 for rx refill?
Replies: 42
Views: 3513

Re: Billing 99212 for rx refill?

Update. The bill is indeed for calling in the prescription refill. I'll pay it, but should I submit for partial out of network reimbursement? I don't see that you have anything to lose by submitting it. If you catch your insurance on a good day they might pay it. But if they ask for supportive docu...
by toofache32
Tue Aug 29, 2017 6:53 pm
Forum: Personal Consumer Issues
Topic: I've fallen and I can't get up -- recommendations?
Replies: 43
Views: 6223

Re: I've fallen and I can't get up -- recommendations?

I bought my dad a button type about 6 or 7 years ago. There's no monthly fee, but if I recall correctly it was expensive ($250?) It's basically a cell phone. Once the button is pushed it starts dialing numbers (or 911). He wouldn't wear it. He's currently 96 and lives alone in his house. Last Chris...
by toofache32
Mon Aug 28, 2017 8:02 am
Forum: Personal Consumer Issues
Topic: I've fallen and I can't get up -- recommendations?
Replies: 43
Views: 6223

Re: I've fallen and I can't get up -- recommendations?

I bought my dad a button type about 6 or 7 years ago. There's no monthly fee, but if I recall correctly it was expensive ($250?) It's basically a cell phone. Once the button is pushed it starts dialing numbers (or 911). He wouldn't wear it. He's currently 96 and lives alone in his house. Last Chris...
by toofache32
Sun Aug 27, 2017 12:49 pm
Forum: Personal Consumer Issues
Topic: I've fallen and I can't get up -- recommendations?
Replies: 43
Views: 6223

Re: I've fallen and I can't get up -- recommendations?

I bought my dad a button type about 6 or 7 years ago. There's no monthly fee, but if I recall correctly it was expensive ($250?) It's basically a cell phone. Once the button is pushed it starts dialing numbers (or 911). He wouldn't wear it. He's currently 96 and lives alone in his house. Last Chris...
by toofache32
Sun Aug 27, 2017 10:59 am
Forum: Personal Consumer Issues
Topic: medigap insurance- did you get excess charges rider?
Replies: 10
Views: 906

Re: medigap insurance- did you get excess charges rider?

Yes thank you, "opted out" is what I was referring to. I think I answered my own question because if this rider is part of the Medicare/Gap/Advantage plans then I assume they won't apply to opted out providers, which means they won't pay.
by toofache32
Sun Aug 27, 2017 10:14 am
Forum: Personal Consumer Issues
Topic: medigap insurance- did you get excess charges rider?
Replies: 10
Views: 906

Re: medigap insurance- did you get excess charges rider?

I'll have to look up the correct terminology, but my question was regarding doctors who have completely opted out of Medicare and are not bound by the 15% rule. I agree the terminology doesn't make sense.
by toofache32
Sun Aug 27, 2017 12:16 am
Forum: Personal Consumer Issues
Topic: medigap insurance- did you get excess charges rider?
Replies: 10
Views: 906

Re: medigap insurance- did you get excess charges rider?

I'm still unclear on what this covers. Is it just for providers who are in that 15% extra charge category? What about providers who are completely out of network and are not limited by the 15% ?
by toofache32
Fri Aug 25, 2017 8:01 am
Forum: Personal Consumer Issues
Topic: Can dispute an expensive medical bill
Replies: 39
Views: 2875

Re: Can dispute an expensive medical bill

Oh dear lord. I am all for calling out other docs for inappropriate billing, but there is NOTHING wrong here. As long as you had the routine eye exam for x dollars that was discussed in advance nothing wrong was done. My guess is during the routine exam the doc. said something like, "Looks like som...
by toofache32
Fri Aug 25, 2017 7:57 am
Forum: Personal Consumer Issues
Topic: Can dispute an expensive medical bill
Replies: 39
Views: 2875

Re: Can dispute an expensive medical bill

samsoes wrote:
Fri Aug 25, 2017 6:02 am
strafe wrote:
Fri Aug 25, 2017 4:12 am
Expensive?? $281 sounds like a bargain for the services received.
Agreed. Methinks the OP needs to redefine what an expensive medical bill really is.
These days, any amount of money is too much. Someone complains regardless.
by toofache32
Thu Aug 24, 2017 10:37 pm
Forum: Personal Consumer Issues
Topic: Can dispute an expensive medical bill
Replies: 39
Views: 2875

Re: Can dispute an expensive medical bill

[ If your husband asked for routine eye exam and was quoted a price of $30 and the tests were provided with no further explanation as if they were part of the exam, I would ask for the charges to be waived. But how? I talked to the lady there she said she could do nothing at this point. I am waitin...