Another day, Another beating up of specialists by the NY Times

[SouthernSurgeon]

Is that really worth $400?

Is walking a patient to the bathroom worth $400? Hell no.

Do you actually believe that is all PTs do? Then you're an idiot.

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[jakeislove]

Is walking a patient to the bathroom worth $400? Hell no.

Do you actually believe that is all PTs do? Then you're an idiot.

I was gonna apply for the job, LOL!

It's entirely possible the walker cost was included.

Does make me wonder how often people pad the bill, though.

 

[Hemorrage]

The real problem is that the physicians are always the first ones to get blamed for high costs. Surgery costs 30k? Must be the surgeon taking 90% of it. The ignorance of american society is absolutely disgusting. Who are the real crooks? The hospital administration, ceo's, bankers, etc. They don't do anything physically tangible for the average human being and yet the first people society throws under the bus are the kids who spent their lives working hard and studying into the wee hours of the night to care for them and their mother when they wake up with a glioblastoma.

This is why we need to support the AMA and make sure their lobbying powers are stronger than ever. Even in medical school there is treason amongst the ranks by these liberalized public health loving kiddies who think badmouthing their own profession is the way to make healthcare better in the states. The old values of loyalty and camaraderie amongst one's peers needs to be brought back. These fools need to realize that by throwing their own under the bus, they're effectively committing professional suicide themselves.

 

[Winged Scapula]

I was gonna apply for the job, LOL!

It's entirely possible the walker cost was included.

Does make me wonder how often people pad the bill, though.

You're making the same assumption patients do.

Before you even walk into the room, you're reviewing the chart, lab results, op note and anything else pertinent. After SAFELY walking the patient down the hall and instructing them on safe mechanics, you are writing a note and making a care plan, and possibly calling the attending to review the care with them.

That's what costs $400, not the actual walking of the patient. The walker would have been billed under DME if the patient went home with it, not under the PT consultation.

This sort of stuff frustrates me; I had the proverbial "doctor's wife" (turned out he was a dentist) refuse to pay me for a post biopsy visit, literally screaming at me and my staff that she was in the global period (she wasn't) and that she was going to report me to the insurance company and the medical board (she didn't). She neglected to think about the fact that I obtained the results of the biopsy I did, called her (after hours mind you) with the results, discussed them with her briefly on the phone, printed out the results for her, discussed them at length with her, assessed her wound and removed her suture and discussed the followup plan with her. If that isn't worth the approximate $60 I would have made, I'm not sure what is.

Oh and she asked me, at her first visit, to waive her co-pay as "professional courtesy".

 

[Hemorrage]

You're making the same assumption patients do.

Before you even walk into the room, you're reviewing the chart, lab results, op note and anything else pertinent. After SAFELY walking the patient down the hall and instructing them on safe mechanics, you are writing a note and making a care plan, and possibly calling the attending to review the care with them.

That's what costs $400, not the actual walking of the patient. The walker would have been billed under DME if the patient went home with it, not under the PT consultation.

This sort of stuff frustrates me; I had the proverbial "doctor's wife" (turned out he was a dentist) refuse to pay me for a post biopsy visit, literally screaming at me and my staff that she was in the global period (she wasn't) and that she was going to report me to the insurance company and the medical board (she didn't). She neglected to think about the fact that I obtained the results of the biopsy I did, called her (after hours mind you) with the results, discussed them with her briefly on the phone, printed out the results for her, discussed them at length with her, assessed her wound and removed her suture and discussed the followup plan with her. If that isn't worth the approximate $60 I would have made, I'm not sure what is.

Oh and she asked me, at her first visit, to waive her co-pay as "professional courtesy".

Bet she has no problem giving her hairdresser $200 to cut her hair

 

[calvnandhobbs68]

Bet she has no problem giving her hairdresser $200 to cut her hair

1000x this

Let me say that I totally agree with price transparency. I believe that is going to be one of the biggest improvements and way to drive down costs in our healthcare system, once we start forcing everyone to put their prices up ahead of time. That being said, once you know what the prices are it's time to pay up.

Crap like people wanting their copays "waived"? Uh no...you don't go to Target and say "hey I come here all the time, can you take the first 20 bucks off?" It's also really sad to me too that it's the people who can afford to pay it who don't want to. How about you just pay the $30 copay and the $60 for the office visit where you were told if you had CANCER or not before you walk out to your 7-series to go pick up your kids from their private high school. THANKS

 

[DermViser]

Oh and she asked me, at her first visit, to waive her co-pay as "professional courtesy".

So in other words, she was asking you to break the rules of your contract with the insurance company that requires you to collect a co-pay, which in some states counts as fraud. How professional of her.

 

[Winged Scapula]

So in other word, she was asking you to break the rules of your contract with the insurance company that requires you to collect a co-pay. How professional of her.

Yes. She wasn't the first.

The biggest offenders are nurses and doctors wives.

 

[DermViser]

Yes. She wasn't the first.

The biggest offenders are nurses and doctors wives.

Do they not realize that in some states, it counts as fraud? (probably not, we should be lucky they know what a deductible is). The copay doesn't even go to you, it goes to the insurance company - nurses and doctors' wives should know better.

 

[altitudinarian]

I always wonder, when US citizens complain about the healthcare system we have, would they be willing to change it into something similar to England's? France's? Japan's? I ask because though it's been reported these other countries have "better services and prices", this is all due to how the economic and political structures in play. It's already difficult enough to educate the entire nation on what is really going on in healthcare. It's a whole other ballgame when it comes to convincing the US to change its ways to have a more transparent healthcare system.

 

[PL198]

I always wonder, when US citizens complain about the healthcare system we have, would they be willing to change it into something similar to England's? France's? Japan's? I ask because though it's been reported these other countries have "better services and prices", this is all due to how the economic and political structures in play. It's already difficult enough to educate the entire nation on what is really going on in healthcare. It's a whole other ballgame when it comes to convincing the US to change its ways to have a more transparent healthcare system.

you're presenting a false dichotomy. it's not either the current system or socialized health care. I'd hate england, france and japan's systems more than ours. people have a problem with access now(so I'm told), so waiting multiple years for basic procedures(a la those 3 countries) would not go too well here. Their service isn't better and the price isn't either. I'd say nothing about the socialized systems is transparent either.

 

[Cytarabine]

you're presenting a false dichotomy. it's not either the current system or socialized health care. I'd hate england, france and japan's systems more than ours. people have a problem with access now(so I'm told), so waiting multiple years for basic procedures(a la those 3 countries) would not go too well here. Their service isn't better and the price isn't either. I'd say nothing about the socialized systems is transparent either.

So far as I'm aware, England is the only country on that list with predominantly socialized medicine. You're spouting off against false dichotomies then lump the French, Japanese, and English systems into the same group? Would you toss Germany in there as well? Taiwan? Canada?

 

[TooMuchResearch]

The real problem is that the physicians are always the first ones to get blamed for high costs. Surgery costs 30k? Must be the surgeon taking 90% of it. The ignorance of american society is absolutely disgusting. Who are the real crooks? The hospital administration, ceo's, bankers, etc. They don't do anything physically tangible for the average human being and yet the first people society throws under the bus are the kids who spent their lives working hard and studying into the wee hours of the night to care for them and their mother when they wake up with a glioblastoma.

This is why we need to support the AMA and make sure their lobbying powers are stronger than ever. Even in medical school there is treason amongst the ranks by these liberalized public health loving kiddies who think badmouthing their own profession is the way to make healthcare better in the states. The old values of loyalty and camaraderie amongst one's peers needs to be brought back. These fools need to realize that by throwing their own under the bus, they're effectively committing professional suicide themselves.

AMA won't help you.

 

[jakeislove]

Yes. She wasn't the first.

The biggest offenders are nurses and doctors wives.

I'm not the least bit surprised at doctor's wives feeling entitled. Forgiving co-pays for physicians (and some family members) has been going on a long time.

People have no idea what it costs to deliver a service.

I agree that the walker would have been billed as a DME and wonder if he misunderstood that part of the bill.

Still curious about the additional surgeon's fees, though. What he would have gotten it the patient had Medicare was too low but it seems odd for an assistant to be reimbursed more than the primary.

 

[PL198]

So far as I'm aware, England is the only country on that list with predominantly socialized medicine. You're spouting off against false dichotomies then lump the French, Japanese, and English systems into the same group? Would you toss Germany in there as well? Taiwan? Canada?

huh? france and japan's systems are absolutely socialized. Taiwan absolutely is and Canada is as well or very close.

 

[Cytarabine]

huh? france and japan's systems are absolutely socialized. Taiwan absolutely is and Canada is as well or very close.

It looks on a little googling like I was taught a definition for socialized medicine that's stricter than what's commonly used, so sorry for that. Regardless, the point remains that all these countries have significantly healthcare systems and it seems odd to blanket statement them

 

[PL198]

It looks on a little googling like I was taught a definition for socialized medicine that's stricter than what's commonly used, so sorry for that. Regardless, the point remains that all these countries have significantly healthcare systems and it seems odd to blanket statement them

well for the sake of this discussion if we don't lump them all together as similar, they are all radically different than the US system. my point was just that the US doesn't have to radically change the structure of it's system, it could just tune it up and cut out the fat to become more efficient.

The USA still has the best healthcare in the world. it's expensive, but that's the cost you pay for citizens who don't take their health into their own hands. that isn't reflective of the medical quality of the country, it's reflective of the prevailing mindset of the nation.

 

[sinombre]

well for the sake of this discussion if we don't lump them all together as similar, they are all radically different than the US system. my point was just that the US doesn't have to radically change the structure of it's system, it could just tune it up and cut out the fat to become more efficient.

The USA still has the best healthcare in the world. it's expensive, but that's the cost you pay for citizens who don't take their health into their own hands. that isn't reflective of the medical quality of the country, it's reflective of the prevailing mindset of the nation.

It's also the price you pay when pharmaceutical companies spend literally twice as much on marketing a drug as they do on R&D, and then charge >$100k a year for it without competition.

 

[jakeislove]

well for the sake of this discussion if we don't lump them all together as similar, they are all radically different than the US system. my point was just that the US doesn't have to radically change the structure of it's system, it could just tune it up and cut out the fat to become more efficient.

The USA still has the best healthcare in the world. it's expensive, but that's the cost you pay for citizens who don't take their health into their own hands. that isn't reflective of the medical quality of the country, it's reflective of the prevailing mindset of the nation.

Do you feel people would be forced to take more ownership if there were fewer medical options? For example: Not adequately managing your diet or health?! No problem! We'll just add more medicines or therapies.

 

[womp]

I think I sadly became a ton more pessimistic about America and democracy in general after becoming a doctor.

Idiocracy seems to be the steady state.

 

[PL198]

Do you feel people would be forced to take more ownership if there were fewer medical options? For example: Not adequately managing your diet or health?! No problem! We'll just add more medicines or therapies.

yes

 

[vokey588]

It's interesting to see some people bashing the patient in the story. From my read, he seems like the model informed and savvy patient. He knew what his insurance covered, made sure his doctor had an established reimbursement rate before surgery, read a book on spine surgery indications, and had employer-provided BCBS insurance (probably quite good) yet he was STILL hit with an unexpected charge of >$100,000 that he was expected to pay out of pocket. That is seriously messed up and I think he had a right to be upset. This patient is a stark contrast to the ignorant patients that so many have complained about in this thread.

Also, I hate conversations about what a physician "deserves" in terms of reimbursement, but some posters are implying this patient was cheap for thinking the huge assistant surgeon's bill was unethical. That charge is for assisting on a surgery yet is 1/5th to 1/6th the average neurosurgeons annual income...for one case. I think it is unethical to demand a patient pay that.

I actually liked that the patient wanted to do right by the orthopedist--the one who evaluated him, consented him for surgery, and was the primary surgeon-- because he thought the reimbursement to Dr. Tindel was too low. He wanted to divide the insurance company's check between the two surgeons. Instead, the neurosurgeon threatened to sue.

 

[PL198]

It's interesting to see some people bashing the patient in the story. From my read, he seems like the model informed and savvy patient. He knew what his insurance covered, made sure his doctor had an established reimbursement rate before surgery, read a book on spine surgery indications, and had employer-provided BCBS insurance (probably quite good) yet he was STILL hit with an unexpected charge of >$100,000 that he was expected to pay out of pocket. That is seriously messed up and I think he had a right to be upset. This patient is a stark contrast to the ignorant patients that so many have complained about in this thread.

Also, I hate conversations about what a physician "deserves" in terms of reimbursement, but some posters are implying this patient was cheap for thinking the huge assistant surgeon's bill was unethical. That charge is for assisting on a surgery yet is 1/5th to 1/6th the average neurosurgeons annual income...for one case. I think it is unethical to demand a patient pay that.

I actually liked that the patient wanted to do right by the orthopedist--the one who evaluated him, consented him for surgery, and was the primary surgeon-- because he thought the reimbursement to Dr. Tindel was too low. He wanted to divide the insurance company's check between the two surgeons. Instead, the neurosurgeon threatened to sue.

Your arguments aren't lining up on the same scope. You talk about what a physician deserves, yet those charges aren't received by the physician. If people were actually getting paid 100k to do an individual operation, the incomes wouldn't be what they are. The patient is the one responsible for knowing the costs involved in utilizing a service. God forbid they pay for the cost of the service they chose with the options they had.

 

[Cytarabine]

well for the sake of this discussion if we don't lump them all together as similar, they are all radically different than the US system. my point was just that the US doesn't have to radically change the structure of it's system, it could just tune it up and cut out the fat to become more efficient.

The USA still has the best healthcare in the world. it's expensive, but that's the cost you pay for citizens who don't take their health into their own hands. that isn't reflective of the medical quality of the country, it's reflective of the prevailing mindset of the nation.

Tune it up and cut the fat sounds so wonderful yet nonspecific. What do you have in mind?

 

[PL198]

Tune it up and cut the fat sounds so wonderful yet nonspecific. What do you have in mind?

Stop making backroom deals with insurance companies, make it more of a free market. Get rid of administrators. Pretty much all of the same things that oklahoma surgery group does. If the gov't really wanted to "fix" our healthcare system, they'd consult those people in a heartbeat.

 

[AFMD]

Those that blame physicians are just as wrong as those that excuse them. The situation is obviously more complicated than "all physicians are greedy and charge too much", which is blatantly untrue. The fact remains healthcare workers and institutions can take advantage of the astonishing lack of price transparency. Of course, there are patients who take advantage of the system in other ways, and much of the extra cost in the system may simply be waste. But things like this do happen, and I'll be damned if I'll just defend them simply because we have the same job.

 

[Jabbed]

"At times, a fully trained physician is called in when a resident or a nurse, who would not charge, would have sufficed."

What a bag of laughs. A half-detailed description of the case and only the patient's perspective on the medicine. Interestingly, it looks like most educated readers read the article and think "there's a billing problem," while most uneducated readers (comments section) read it and think that "there's a doctor problem."

 

[PL198]

Those that blame physicians are just as wrong as those that excuse them. The situation is obviously more complicated than "all physicians are greedy and charge too much", which is blatantly untrue. The fact remains healthcare workers and institutions can take advantage of the astonishing lack of price transparency. Of course, there are patients who take advantage of the system in other ways, and much of the extra cost in the system may simply be waste. But things like this do happen, and I'll be damned if I'll just defend them simply because we have the same job.

That doesn't really make logical sense though if you look at the career ROI between physicians and people in administrative positions in medical care. If there was exploitation on the physician's part, their ROI would be stupid high, even though it's lower than ever now.

 

[Winged Scapula]

Do they not realize that in some states, it counts as fraud? (probably not, we should be lucky they know what a deductible is). The copay doesn't even go to you, it goes to the insurance company - nurses and doctors' wives should know better.

No I don't think they know. I know for a fact it wasn't something that I learned in medical school or even residency so I would not expect them to know.

I'm more bothered by the idea that someone who can afford it are asking for the discount. I've got uninsured patients who appeared to be in a lower SES who don't ask for discounts when quoted a price.

 

[AFMD]

That doesn't really make logical sense though if you look at the career ROI between physicians and people in administrative positions in medical care. If there was exploitation on the physician's part, their ROI would be stupid high, even though it's lower than ever now.

I agree, as will most, that the return on investment for a medical education is much lower than it has been, and there are much easier ways to make money. I have no idea how this relates to physicians or hospitals that take advantage of the system. If this is your rational for thinking 100% physicians are 100% honest all the time are are fine with making no money, then that is your right.

 

[PL198]

I agree, as will most, that the return on investment for a medical education is much lower than it has been, and there are much easier ways to make money. I have no idea how this relates to physicians or hospitals that take advantage of the system. If this is your rational for thinking 100% physicians are 100% honest all the time are are fine with making no money, then that is your right.

Well I would say that medicine has become less transparent over time and thus if there was exploitation it would have naturally increased and the relative financial position of physicians would have improved.

 

[Winged Scapula]

.

Still curious about the additional surgeon's fees, though. What he would have gotten it the patient had Medicare was too low but it seems odd for an assistant to be reimbursed more than the primary.

Assistants can definitely make more than the primary provider if they are out of network.

I've been on both sides of the coin here: once being paid more for assisting my partner because I was out of network and another time where my assistant made five times what I made because he was out of network.

I understand patients frustration with this system. Patients will occasionally ask me if I'm sure that the anesthesiologist is in their network. Frankly I have no idea nor do I know whether the pathologist is etc. It's upsetting enough to deal with cancer but then be hit with an out of network bill when you thought everything would be covered.

 

[SouthernSurgeon]

I understand patients frustration with this system. Patients will occasionally ask me if I'm sure that the anesthesiologist is in their network. Frankly I have no idea nor do I know whether the pathologist is etc.

This kind of stuff seems crazy to me.

I mean obviously I'm in an AMC so everything is one network. I'm insulated from it.

But hospitals with differing private groups, it seems like there should be some better way to coordinate

 

[AFMD]

Well I would say that medicine has become less transparent over time and thus if there was exploitation it would have naturally increased and the relative financial position of physicians would have improved.

I think that what you are arguing is that the vast majority of physicians are honest and have the best interests of the patient in mind, and I would agree. However, to extend this tendency to 100% of all physicians 100% of the time is quite a stretch. By this same logic we might assume that all drug dealers are honest because they have a poor ROI for their profession (taking into account risk of imprisonment). Judging how moral someone is by how much money they make, their return on investments, or whatever is a a seriously flawed argument.

And this kind of thinking only hurts the profession. As we police ourselves less, the state will likely take over.

Let's be honest about the issues, and deal with them, instead of burying our head in the sand. I think you would agree.

 

[PL198]

I think that what you are arguing is that the vast majority of physicians are honest and have the best interests of the patient in mind, and I would agree. However, to extend this tendency to 100% of all physicians 100% of the time is quite a stretch. By this same logic we might assume that all drug dealers are honest because they have a poor ROI for their profession (taking into account risk of imprisonment). Judging how moral someone is by how much money they make, their return on investments, or whatever is a a seriously flawed argument.

And this kind of thinking only hurts the profession. As we police ourselves less, the state will likely take over.

Let's be honest about the issues, and deal with them, instead of burying our head in the sand. I think you would agree.

I'm not saying they are 100 % honest. No profession is. I'm saying if there was an egregious amount of exploitation the relative economic standing of physicians would be different than it is now.

 

[AFMD]

I'm not saying they are 100 % honest. No profession is. I'm saying if there was an egregious amount of exploitation the relative economic standing of physicians would be different than it is now.

Then I think we agree.

 

[vokey588]

Your arguments aren't lining up on the same scope. You talk about what a physician deserves, yet those charges aren't received by the physician. If people were actually getting paid 100k to do an individual operation, the incomes wouldn't be what they are. The patient is the one responsible for knowing the costs involved in utilizing a service. God forbid they pay for the cost of the service they chose with the options they had.

Did you read the article? The assisting surgeon demanded and was paid the full amount because he was out-of-network for the patient. I would say that the patient in the article fulfilled his responsibility as well as you could expect from a layperson (see my previous post for the measures he took). He wasn't told there would be a neurosurgeon assisting, let alone that he charges an out of network fee for assisting. Even if the patient is a knowledgeable health care worker, there's no way to know if the assistant will be a surgeon, PA, or scrub tech if you aren't told ahead of time, and no layperson could be expected to know that.

 

[PL198]

Did you read the article? The assisting surgeon demanded and was paid the full amount because he was out-of-network for the patient. I would say that the patient in the article fulfilled his responsibility as well as you could expect from a layperson (see my previous post for the measures he took). He wasn't told there would be a neurosurgeon assisting, let alone that he charges an out of network fee for assisting. Even if the patient is a knowledgeable health care worker, there's no way to know if the assistant will be a surgeon, PA, or scrub tech if you aren't told ahead of time, and no layperson could be expected to know that.

then it's their job to find out. I'm not expected to know what " balancing and rotating my tires" entails, yet it's still my responsibility to learn and figure out the time and materials required unless I want to a) risk getting screwed b) put complete faith in the person carrying out the services.

 

[HoboCommander]

Healthcare is expensive but most of the money does not go to the surgeons. I've never heard of neurosurgeons making $117k on one case. In a case of mass fraud, neurosurgeons made $10k per case at a secret hospital and got filthy rich. But more than that is unheard of.

If we Americans want cheaper health care, we have to accept a lower quality of service. Training neurosurgeons is extremely expensive, plus they have their own $400k in loans they got to pay back. In other countries, you cut out the 4 years of college and go straight to medical school out of high school. They have like $10k in loans. For primary care, I think the years of residency can be seriously cut, and make 4th year medical school be the intern year. New doctors can learn on the job just like PA's today. Quality does down but health care cost will go down dramatically.

 

[Winged Scapula]

This kind of stuff seems crazy to me.

I mean obviously I'm in an AMC so everything is one network. I'm insulated from it.

But hospitals with differing private groups, it seems like there should be some better way to coordinate

Its very frustrating for me as well.

I've gotten agreements from my anesthesia and pathology groups to accept CMS fee schedules for out of network patients, but the problem is because its out of network, it gets billed to the patient rather than to their insurance, the patient freaks out at the billing amount (rather than the amount the group would accept for payment), it goes back and forth between the patient, the group and their insurer before the latter finally pays (in most cases) because there was no in network anesthesiologist or pathologist at the hospital (so have to accept out of network charges). All the while the patient is upset.

 

[Armadillos]

This is so screwed up, Some guy appears to try to do his homework and make responsible financial decisions and then gets hit with a 100K bill from someone he has no knowledge or relationship with. Thats absolutely insane.

Lets say he actually pays up this 110K in fees for the extra surgeon, whats the breakdown of what percent of that 110K goes to who? (Before taxes)

 

[PL198]

This is so screwed up, Some guy appears to try to do his homework and make responsible financial decisions and then gets hit with a 100K bill from someone he has no knowledge or relationship with. Thats absolutely insane.

Lets say he actually pays up this 110K in fees for the extra surgeon, whats the breakdown of what percent of that 110K goes to who? (Before taxes)

wut. how does taxes change the percentage and how would that even matter? here's a little persona testimony. my dad got a quad bypass a month ago, was in hospital 5 days prior and a week after. surgeon did the bypass(obviously) as well as came in to his room every day he was in the hospital. surgeon got paid 4k.

 

[vokey588]

wut. how does taxes change the percentage and how would that even matter? here's a little persona testimony. my dad got a quad bypass a month ago, was in hospital 5 days prior and a week after. surgeon did the bypass(obviously) as well as came in to his room every day he was in the hospital. surgeon got paid 4k.

I'm still not sure you read the article. The neurosurgeon in question was simply assisting, he was not the primary surgeon. The CT surgeon in your dad's case was the primary surgeon.

 

[PL198]

I'm still not sure you read the article. The neurosurgeon in question was simply assisting, he was not the primary surgeon. The CT surgeon in your dad's case was the primary surgeon.

I understood that when I read it, much like I understand it the multiple times it's been repeated.

 

[DermViser]

This is so screwed up, Some guy appears to try to do his homework and make responsible financial decisions and then gets hit with a 100K bill from someone he has no knowledge or relationship with. Thats absolutely insane.

Lets say he actually pays up this 110K in fees for the extra surgeon, whats the breakdown of what percent of that 110K goes to who? (Before taxes)

He didn't. His insurance company paid the bill in full --- LIKE THEY SHOULD HAVE.

 

[wjs010]

What a *****

 

[sazerac]

I think what we all want to know is, does the assistant get to keep all $110,000 himself? Does the hospital take $106,000 in administrative fees, leaving him with $4,000?

This out-of-network stuff stinks to high heaven. Two hospitals could make a fortune by sending all their employees to each other's facilities, to create maximum out-of-network fees.

 

[SouthernSurgeon]

I think what we all want to know is, does the assistant get to keep all $110,000 himself? Does the hospital take $106,000 in administrative fees, leaving him with $4,000?

This out-of-network stuff stinks to high heaven. Two hospitals could make a fortune by sending all their employees to each other's facilities, to create maximum out-of-network fees.

I have no idea in this particular case, but the actual surgeon's fees/assistants fees that a surgeon collects - in network or out of network - are nowhere close to that. I mean that should be intuitively obvious or else every surgeon would just do 10 out of network cases a year and make 1 million dollars.

 

[DermViser]

I think what we all want to know is, does the assistant get to keep all $110,000 himself? Does the hospital take $106,000 in administrative fees, leaving him with $4,000?

This out-of-network stuff stinks to high heaven. Two hospitals could make a fortune by sending all their employees to each other's facilities, to create maximum out-of-network fees.

Do you even know what out-of-network means? As the policy holder it is your job to find out whether you provider is out-of-network for your particular insurance.

 

[PL198]

Do you even know what out-of-network means? As the policy holder it is your job to find out whether you provider is out-of-network for your particular insurance.

That's what people don't get. Like it's up to the patient to determine who is covered by their plan.... It's not the physicians job to hold their hand and plan out a method for maximal value on behalf of the patient. Jesus H Christ some of you act like you literally owe patients your lives.