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Originally Posted by CoachKandSportsguy
Read an interesting view on using Medicare as catastrophic insurance and paying cash for PCP physicals and other appointments.
Thought that was an interesting view, such that PCPs would not shun time and tests with the patient, given the low reimbursement rate by Medicare.
One MD stated that based upon the insurance payments for annual physicals, the max time spend with a patient, include prep and review time, would be 10 minutes. Some insurance companies reimburse $28 for an annual physical. No wonder PCPs don't want many elderly patients.
Paying full freight for the physician's services would make sense once a year, not sure if that included blood work, etc, maybe not, as the pop doesn't benefit from that payment
any point counterpoint arguments for or against it?
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OK, counterpoint argument-----
Now, my numbers are 10 years old, so reimbursement is probably 10-20% higher now, but.....
Medicare does not pay for "annual physicals" at all----it is considered preventative care, and they only pay if the patient has a diagnosis.
However, since everyone 65+ has some diagnosis, the physician can code the encounter as 99215 as long as they meet documentation criteria. That reimbursement was about $120 10 years ago.
Most Medicare rates only run about 10-15% below the best private insurers and is actually higher than some.
Also, I wouldn't try to obtain a new physician stating that you are just going to pay out of pocket----the saying in the medical field is "self-pay = no pay", and that is often true.