Quote:
Originally Posted by valuemkt
And reductions in Medicare reimbursements to doctors and hospitals only end up having them charge more to the non-Medicare people. Have you ever seen a doctor or hospital take a pay-cut?
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Huh? Lets start with "Fee Schedules". Medicare will pay $X for Procedure "Y". From there, ALL providers create a fee schedule from the known minimum (medicare). This fee is typically Medicare + Z%. So, "cash pay" would essentially be "Medicare+X%". Insurance companies who are contracted to providers will pay "Medicare+Q%" on certain procedures.
So - if your sympathetic joint effusion has a reimbursement of $1.00 from Medicare....
$1.00 (what Medicare pays)
$0.15 (what Medicaid pays - when they get around to it)
$1.30 (what BCBS will pay to an in-network provider)
$2.00 (cash pay fee schedule for WorkComp/PI - knowing it will take years to get paid)
To claim that providers are jacking their price to "cover" Medicare is foolish...they only "cover" Medicaid...and most simply do not accept Medicaid as it never pays a bill let alone a steeply discounted bill.
Have I seen providers take a pay cut? LOL, you have GOT to be kidding. Medicare no longer pays for MANY high level hospital consults. They dont pay for many diagnostic visits nor much of the DME/Supplies used.