But even with traditional indemnity these SOB's get you to negotiate down your fees to the agreed upon rate. I'm talking real free market that the customer gets some or all assistance for. We all set our charges based on our own freemarket thoughts and needs, and supply and demand. We then charge and get paid truly the same from everyone no matter who they are or what form of payment method. With my local BCBS traditional patients there is still a difference between my charges and what they will pay and we can not by law or by contract collect the difference between our charges and the strong armed "Argeed Upon Rate".
Again just think about the gallon of milk and Food Stamps. You're downstate, right? So Walbaum's charges everybody $3 per gal for milk no matter who they are. And they all pay $3 a gal no matter who they are, right. So whether cash (Private pay), credit (different private insurance), or Food Stamps (Medicare or Medicaid,let's say) they all pay the same and at time of service too.
No cash, credit or food stamps in hand, no milk, to bad. It's up to the gov't to supply the right amount of food stamps for any person or family, for those who need it based on whatever formulas they choose to use. Hopefully they actually observe the cost of living and what things cost. But we the providers, just the the Supermarkets right now, don't get asked to assist in the financing and proping up the broken system by making us accept less for the same services or products.
Nobody in their right mind, even on food stamps thinks that they should be able to walk into Walbaum's and walk out with a gal of milk (baby food, very important) without cash, credit or food stamps. And again, it's the finally being able to charge and actually "get" a market based rate and charges for our services. Then we charge what we want to and let the customer shop where they will for whatever reasons they have, be they cost, convienence, service, quality or what have you. I don't care what your insurance is because I charge and get paid the same no matter what, based on my reasons and the market my business is based in.
BUT, Once we all PAR then we all cost exactly the same, right? We all watch our fee schedules and remits and set our rates based on the rules of the game as it presently stands. So, all the patients pay all PAR docs the same thing for the same services in the same part of the country or the state. Just where the hell is the "free market" in any of that? It's a bold face lie and we all know it. But, the FTC is in bed with our pols and the carriers and keeps getting this very wrong. And gov't continues to write laws that only make this all even worse.
It can't really be a free market until we can charge and get what we charge in full at time of service. Only when nobody is allowed to PAR, can it be considered a real freemarket. The way I see it, the present system is really a form of gov't supported price fixing against all of us. In the same town, if we both PAR then the local BCBS will pay us both exactly the same and not a dollar more. And it costs the patient exactly the same then too. If that's not reverse price fixing against the merchant then tell me what is? Come on, please....
If a Supermarket can be treated with at least this amount of respect then why not a licensed provider of medical services?
"Good Night and Good Luck"
Paul
