Originally posted by Tyrone Bigguns
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Originally posted by the_idle_threatWell then do it.Originally posted by Tyrone BiggunsAre you sure about that?Originally posted by Deputy NutzFor instance under medacare a Radiologist can only charge 13.00 bucks for an x-ray, an HMO pays 57.00 dollars. You do the math.Originally posted by MJZiggyI'm curious as to why you say that. The government pays its higher end professionals quite well. It's the lackeys that suffer for pay, though the bennies are great.
I can verify the amount in a about 2 minutes with one call.
The rate for medicare for an x-ray is low. Not sure the exact amount, nor do most radiologist know the amount...the guess was anywhere from 13-25. What they do know is that it is a loss leader. In the sourced referenced, the firm loses 3 mill a year on x-ray, but actually will recoup that as they are moving to digital.
I can tell you this right off the top of my head from many conversations.
First, medicare doesn't set any sort of national reimbursement..it is done regionally. Different zones get different fees. It basically comes down that the gov't pays X amount of dollars per region. If the region is high pop then you get a lower per person reinbursement. If the region is sparsely populated, you get more person. Basic biz...the doc gets the "same" amount of money..high volume at lower rates or low volume at higher rate.
Second, the HMO amount..disparity between medicare and HMO isn't correct. Generally, HMO's pay 5% less then medicare to 10-15% above. Radiologists would orgasm over the disparity suggested by Nutz. Now, i'm not going to say that his figure is 100% incorrect as their may be some wacko situation out there, but it isn't close to the norm.
And, it only makes sense. Why would an HMO pay that much more. Bad biz decision. They would if they had to, but since doctors can't refuse medicare patients...no need for HMO's to pay this high.
To look at an x-ray and view it by dollars only is foolish. For example in any given day 50% of patients will be plainfilm. The rest are petscan, catscan, mri, ultrasound, etc. Those make dollars for the company.
Now, outta of those x-ray patients, most will not just get an x-ray. A low percentage of doctors refer a patient to a radiologist and just ask for an x-ray. Conversely, doctors won't send patients to imaging centers that only do the profitable procedures.
I'm not saying that every person sent has multiple procedures, but after the x-ray, a great percentage come back for follow up tests. For example, you get a spinal plainfilm. It shows abnormalities..boom, you got more tests coming.
In Nutz's example, the radiologist charges X amount of dollars. But, that kinda makes it out like the radiologist makes a determination of which customer to see. Wrong. They get no choice as they are referred patients.
Radiologists are, to make an example, like car techs. If you bring in your car and the service manager/lead mech determines the work..it goes to the tech to work on it. The tech doesn't determine what work is to be done. Now, the tech certainly can relate information back..your hoses are going. But, the tech can't just say...i'm going to fix these and charge you for them..well, they can, but then you scream at them for unauthorized work. this may not be a perfect analogy, but i think you see where i'm going.
Now, the dealership may charge X amount for work done for guys like you and me, but another X amount with the local taxi company. But, the tech isn't involved in charging.
Essentially an x-ray is like the 19 oil change. Somehow we always seem to pay more for it..coolant, etc.
Hope this helps.
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Just becauase Tyrone lives in a box and has no insurance doesn't mean he isn't down with the issues.Originally posted by the_idle_threatYou see ... now we learned something. Didn't know a guy who lives in the alley in a box would know so much about HC.
Tyrone wasn't always homeless. Tyrone did had a mother and father and siblings.
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