G*******n
发帖数: 235 | 1 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: Gottingen (平平安安), 信区: MedicalCareer
标 题: 求助！求相关的医学资料，谢谢
发信站: BBS 未名空间站 (Wed Mar 21 18:47:45 2012, 美东) | A*******s
发帖数: 9638 | 2 找你的医生去吧， 谁让你做的检查， 谁就是权威。 | x********g
发帖数: 268 | 3 I doubt the doctor will have much say in this. Many insurance companies
will only cover those tests when the patients are over a certain age or
have complications in their pregnancy.
But, rule of thumb, always ask your doctor, and always argue with your
insurance.
【在 A*******s 的大作中提到】
: 找你的医生去吧， 谁让你做的检查， 谁就是权威。
| A*******s
发帖数: 9638 | 4 If the doc ordered a wrong test, no charge should be submitted to insurance
company.
【在 x********g 的大作中提到】
: I doubt the doctor will have much say in this. Many insurance companies
: will only cover those tests when the patients are over a certain age or
: have complications in their pregnancy.
: But, rule of thumb, always ask your doctor, and always argue with your
: insurance.
| x********g
发帖数: 268 | 5 The ob billing is quite tricky. For a regular, no complication pregnancy
and delivery, it's usually billed as global. Included in the global can be
several different standard tests. If there is complication, insurance
company requires it to be billed as complication/individual visits. However
, most ob offices won't do that, because it's too much work, and they
continue to bill as global, therefore some of the tests will fall through
the cracks.
Did the doctor order the wrong tests? No idea, most ob offices have on site
ultrasound service, so there you go.
So, as a patient, I would double check with my insurance to make sure a test
is covered before it is carried out, NOT after.
insurance
【在 A*******s 的大作中提到】
: If the doc ordered a wrong test, no charge should be submitted to insurance
: company.
| A*******s
发帖数: 9638 | 6 The patient owes clinic/physician money, not the insurance. If the
insurance refuses to pay, the clinic has to cooperate with insurance policy
and resubmit the clinical evidence for an appeal. Otherwise, the clinic has
to eat the bill.
be
However
site
test
【在 x********g 的大作中提到】
: The ob billing is quite tricky. For a regular, no complication pregnancy
: and delivery, it's usually billed as global. Included in the global can be
: several different standard tests. If there is complication, insurance
: company requires it to be billed as complication/individual visits. However
: , most ob offices won't do that, because it's too much work, and they
: continue to bill as global, therefore some of the tests will fall through
: the cracks.
: Did the doctor order the wrong tests? No idea, most ob offices have on site
: ultrasound service, so there you go.
: So, as a patient, I would double check with my insurance to make sure a test
| x********g
发帖数: 268 | 7 You are correct in saying the patient owes the clinic money. In other
medical cases, submitting evidence is sufficient for an appeal, but in OB
cases, the clinic has to re-do the entire billing (ur, how many visits that
patient had during those 40 weeks?) if there is complication involved but
billed as global. I doubt a clinic will do that. :)
Clinic eating the bill? Oh well, I have seen signs posted on the check in
window at some OB doctors' office, "All balance has to be paid in full
before you can be seen by our physicians." The question for a patient then
becomes, do you like the doctor enough to stay with him/her and pay the bill
yourself? |
|
