The first step to liberation from government third party intrusions is for physicians to transition from participating to Medicare non-participating providers. Even though patients are getting reimbursed, they become much better stewards of their healthcare dollars, and their questions regarding tests and procedures has restored the dialogue that went missing when “insurance” paid for it. They also become aware of the cost of their care.
Here is my letter to my Medicare patients:
To My Medicare Patients:
As many of you know, Medicare utilizes payment reductions to physicians to curb costs. As an example, my fee for cataract surgery is $2,000 which I have not changed since 1986. The current Medicare fee schedule dictates my fee to be $696.60, which also includes ninety days of post-operative care. The maximum they pay is 80% of that fee. What many people do not understand is that a secondary policy only picks up the 20% difference between what Medicare pays and what they allow, NOT the physician’s actual fee. I am happy to provide a list of my fees and what Medicare pays. Facing further cuts in what Medicare allows, in 2010 I made the decision to become a non-participating provider so that I could continue to serve my Medicare patients. What does this mean for you and me?
The way in which you take care of your financial obligation to me is as follows. You will pay our office at the time of services are rendered. We will explain any procedures and their cost, and you will be informed prior to any test or procedure that is not covered by Medicare. We will electronically file your claim for you with the appropriate codes to Medicare and your secondary insurer where applicable. They will send you a reimbursement check. Most people receive reimbursement within 21 days.
Medicare entices physicians to be participating providers by electronically depositing Medicare payments to the physician directly into their practice’s bank account. In return for this expedited payment, Medicare pays the physician 15% less than a non-participating provider. By becoming a non-participating provider I will be able to continue to see you sustaining less of a loss from my customary fees as further cuts in Medicare continue to be a reality. Many physicians have decided to opt out of Medicare completely. This means no payment from Medicare to the patient or to the physician. I have not made that decision as yet because you are an integral and very rewarding part of my practice. Furthermore, you have contributed money to Medicare believing that it would provide the promised insurance benefits. It is not the fault of Medicare patients or physicians that the Federal Government has grossly mismanaged this healthcare insurance program to the point of estimated insolvency as early as 2020.
I will continue to work in many venues to preserve the sanctity of the physician-patient relationship and access to the high quality of care and technology that we currently enjoy. I hope that you will do the same in whatever ways you can. The system needs fixing, but the ObamaCare legislation, with over $500 billion in Medicare funding cuts, does not bode well for the future. Together it may not be too late for us to take back control of our own healthcare decisions. If you are interested in what real reform looks like, you may visit a website for an organization I co-founded, AmericanDoctors4Truth.org and read The Plan.
I have been privileged to enjoy the best of the traditional physician-patient relationship with many of you and your families for years. You are more than “patients” to me. I am hopeful that this arrangement does not pose an undue hardship on any of you. My staff and I will work with you as needed.
Jane Lindell Hughes, MD, FACS
Photo by Alan Cleaver