Archive for category Dr D reactions
Ok. It isn’t cosmetic, but I do have a reconstructive practice too. My reconstructive practice has become more and more a Medicare practice as Medicare is the last of the plans for which I am a Provider. “Provider” really should be a dirty word in plastics as overhead usually makes it a loser economically. My overhead does not become any lower just because your insurer wants to pay me poorly. I do not deny patients appointments at the office but I cannot obviously guarantee that their insurers will pay the bill. I will no longer bill Workman’s Compensation. Patient who have insurance with “Out of Network” benefits usually get some coverage however.
Workman’s Compensation actually used to pay pretty well. Now most W/C plans pay less than Medicare. They also take 3-8 months to pay. I look at Medicare as a service to the retired community. I owe no such favor to the Workman’s Compensation insurers. My last few W/C patients have been favors.
Besides lousy pay, Workman’s Compensation comes with other great benefits:
(1) Paperwork by the ream. Little if any of this is compensated.
(2) Patients with a high propensity to be involved in litigation with their employers. This draws me away from my patients with phone calls from pushy attorneys looking to pad their pockets, occasional threats from such attorneys and court time.
John Di Saia MD
Just curious. I think it’s fun to speculate on who’s had what done, shake our heads at those who try to deny the fact that they’ve obviously been altered, but why is there usually a negative stigma attached to getting it done? If a person chooses to spend their own money to modify their own body to feel better about how they look, what’s the harm?
Some people frown upon all unneeded surgery. Cosmetic surgery is the ultimate in unneeded surgery particularly if the outcome seems freakish. This is philosophy on the most basic level. That which one person finds horrible another may find attractive.
In looking at pics of celebrities it can often be hard to tell what changes are due to aging and what might be from surgery. The interface between the two is one of the hardest things to predict. It is entertainment to discuss entertainers and their possible plastic surgery. We rarely know for certain whether anything has been done except when it appears really horrible or really great.
John Di Saia MD
I receive offers to be included in class action suits a few times a year. Lawsuits supposedly on behalf of physicians against health care insurers are becoming more common. As far as I am concerned, all insurance companies play games in the process of approvals and payment for care. I have not seen a notable exception to this statement.
Name another business in which payment for a service often takes months even when approval has been obtained in advance. How about a business in which the contractor cannot determine the rates for their services? Or better yet one in which the discount taken by the company (the so called Provider discount) is routinely two thirds of the charge. I honestly don’t know how Provider doctors make a living!
These suits get me from two opposing viewpoints:
(1) Good. They (the insurers) are getting theirs.
(2) Bad. Funds that should have been paid to physicians are just going to lawyers. These suits generally enrich the law firms much more reasonably than they do the doctors for whom the suits are supposedly being filed.
John Di Saia MD