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Addiction 2022.2

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Road Cycling “It is by riding a bicycle that you learn the contours of a country best, since you have to sweat up the hills and coast down them. Thus you remember them as they actually are, while in a motor car only a high hill impresses you, and you have no such accurate remembrance of country you have driven through as you gain by riding a bicycle.” -- Ernest Hemingway

Addiction 2022.2

Old 06-17-22, 09:52 AM
  #8901  
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Originally Posted by datlas
Way more time but fees are dictated by insurance companies so same payment.
Out they go. Only profitable patients accepted.
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Old 06-17-22, 10:01 AM
  #8902  
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Originally Posted by Mojo31
No wonder you are thrifty. ☹️
??
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Old 06-17-22, 10:02 AM
  #8903  
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Originally Posted by Mojo31
Out they go. Only profitable patients accepted.
Thats what is happening in BH space. Private pay only, nobody takes insured patients.
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Old 06-17-22, 10:06 AM
  #8904  
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Originally Posted by seedsbelize2
It's occurred to me that both your kids are now in school.
My daughter starts kindergarten in the fall. My son still hasn't yet wrapped up his school year.

Originally Posted by seedsbelize2
Do you tend to do your vacuuming at the same time everyday? Floors? Laundry? Kitchen cleanup? Daytime soaps and gameshows?
Depends on whether or not I have mimosa plans with the girls. Do you tend to sever fingers at the same time every day? Mow rocks? Pass out on rides?
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Old 06-17-22, 10:14 AM
  #8905  
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Thank you for mentioning Karma Police - been listening to Radiohead since
.
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Old 06-17-22, 10:15 AM
  #8906  
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Originally Posted by phrantic09
??
At $125/20minutes, the most he can make on a gross basis is $375/hr. When you consider the overhead, that’s not very good, in my opinion, for someone with his experience. And, we all know that not every minute of every hour is billable. From what I’ve seen, the average profit margin for a private practice is about 15%. That means that Doug may make $56/hr if that is correct for his practice.
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Old 06-17-22, 10:17 AM
  #8907  
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Originally Posted by WhyFi
My daughter starts kindergarten in the fall. My son still hasn't yet wrapped up his school year.



Depends on whether or not I have mimosa plans with the girls. Do you tend to sever fingers at the same time every day? Mow rocks? Pass out on rides?
Don’t forget about lunch and afternoon coffee with the girls as well.
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Old 06-17-22, 10:19 AM
  #8908  
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Originally Posted by Mojo31
Out they go. Only profitable patients accepted.
A benefit of working at independent shops was the ease of firing a customer before they cost you too much money. At the dealer it's pretty difficult to get rid of a customer and usually easier to just deal with them. You have to have a pretty solid case against them to get the factory on your side, like threats of violence, etc. Or if you can prove they tried to commit warranty fraud. Just being a disgusting pig or a PITA isn't enough.

Even people with old neglected cars will cry to the factory "I'm never buying another Chevrolet and I'm telling everyone I know".

The factory determines billing times for warranty work, which was the bulk of what I did. A typical "check engine light" job for me would pay .2 or .3 plus .3 for diagnosis. So I got paid half an hour per car. Get the work order, find the keys and the keys of other cars blocking it in if we were busy. Bring it in, hook up diagnostic tools and decide what part to replace. Go to parts and explain what you want. If they have it, go put it on the car, test drive, clear codes, return old part and have it signed off. Park car and turn in keys. You do that 16 times in a day and you make 8 hours. Roughly. Of course bigger jobs pay more and if the customer is paying it's a one hour minimum.
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Old 06-17-22, 10:19 AM
  #8909  
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Originally Posted by seedsbelize2
What do you charge someone who pays cash?
Most of my cash-pay patients have lost their insurance and are going through tough times. So often I see them for free or a token $25 co-pay and waive the rest. If I know they are doing OK maybe $50.

No wonder I am still driving a 1998 Saturn!!
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Old 06-17-22, 10:20 AM
  #8910  
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Originally Posted by Velo Vol
You don't seem to be much of a happiness guru these days, frankly.
I'm sorry I'm not meeting your expectations.
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Old 06-17-22, 10:21 AM
  #8911  
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Originally Posted by Mojo31
At $125/20minutes, the most he can make on a gross basis is $375/hr. When you consider the overhead, that’s not very good, in my opinion, for someone with his experience. And, we all know that not every minute of every hour is billable. From what I’ve seen, the average profit margin for a private practice is about 15%. That means that Doug may make $56/hr if that is correct for his practice.
It’s not good, but also consider I saw my doctor for about 5 of those 20 minutes. That’s also a lower level code and a 3 or 4 will pay more than that.

Regardless, family practice physicians get screwed.
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Old 06-17-22, 10:22 AM
  #8912  
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Originally Posted by phrantic09
Thats what is happening in BH space. Private pay only, nobody takes insured patients.
What is BH space?

I think the thrifty was directed at datlas.
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Old 06-17-22, 10:22 AM
  #8913  
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Originally Posted by big john
What is BH space?

I think the thrifty was directed at datlas.
Behavioral Health.
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Old 06-17-22, 10:23 AM
  #8914  
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Originally Posted by Velo Vol
he doesn't look like a serious cyclist. How dare he defame our good name!
#FauxRage

Last edited by DougRNS; 06-17-22 at 10:37 AM.
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Old 06-17-22, 10:24 AM
  #8915  
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Originally Posted by phrantic09
It’s not good, but also consider I saw my doctor for about 5 of those 20 minutes. That’s also a lower level code and a 3 or 4 will pay more than that.

Regardless, family practice physicians get screwed.
As mentioned above, I don’t know squat about medical billing, so add that caveat to my comments.

I know that I want my docs to make good money and not be disgruntled.
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Old 06-17-22, 10:31 AM
  #8916  
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Originally Posted by phrantic09
Thats what is happening in BH space. Private pay only, nobody takes insured patients.
do they take A$$, gas or grass?
#70'sBumperStickers
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Old 06-17-22, 10:33 AM
  #8917  
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Originally Posted by datlas
Most of my cash-pay patients have lost their insurance and are going through tough times. So often I see them for free or a token $25 co-pay and waive the rest. If I know they are doing OK maybe $50.

No wonder I am still driving a 1998 Saturn!!
I wish my dentist would help me a little like that. I have an elaborate history with him and have spent a butt-load there over the last 25+ years. Since I retired he doesn't accept my medicare advantage ( my PCP does ) and I have been paying cash for 3 years. My previous insurance paid about half.
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Old 06-17-22, 11:01 AM
  #8918  
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Originally Posted by Mojo31
I know that I want my docs to make good money and not be disgruntled.
Same.
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Old 06-17-22, 11:02 AM
  #8919  
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Originally Posted by datlas
Most of my cash-pay patients have lost their insurance and are going through tough times. So often I see them for free or a token $25 co-pay and waive the rest. If I know they are doing OK maybe $50.

No wonder I am still driving a 1998 Saturn!!
I pay $150 a visit for a masters level psychologist for therapy and $300 for my med management appointments with a psychiatric nurse practitioner
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Old 06-17-22, 11:05 AM
  #8920  
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Originally Posted by phrantic09
I pay $150 a visit for a masters level psychologist for therapy and $300 for my med management appointments with a psychiatric nurse practitioner
Ouch. And your health insurance does not pick up at least some of that??
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Addiction is all about class.
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Old 06-17-22, 11:10 AM
  #8921  
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Originally Posted by datlas
Ouch. And your health insurance does not pick up at least some of that??
Nobody accepts patients with insurance. You have to private pay.
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Old 06-17-22, 11:11 AM
  #8922  
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Originally Posted by DougRNS
I'm sorry I'm not meeting your expectations.
You can demonstrate true remorse by ending you '70s references.
Originally Posted by DougRNS
#70'sBumperStickers
Originally Posted by datlas
Most of my cash-pay patients have lost their insurance and are going through tough times. So often I see them for free or a token $25 co-pay and waive the rest. If I know they are doing OK maybe $50.
Telemedicine too?
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People here don't get it.
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Old 06-17-22, 11:12 AM
  #8923  
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Originally Posted by phrantic09
Nobody accepts patients with insurance. You have to private pay.
That would not be sustainable around here. We have to accept assignment.
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Originally Posted by rjones28
Addiction is all about class.
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Old 06-17-22, 11:17 AM
  #8924  
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Originally Posted by datlas
That would not be sustainable around here. We have to accept assignment.
It’s really only behavioral health, but there’s such a shortage of clinicians and lack of access they can get away with it.

They are forcing private pay because if they accept assignment, they can’t balance bill.
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Old 06-17-22, 11:36 AM
  #8925  
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Originally Posted by Velo Vol

Telemedicine too?
Yes. IBC (Independence Blue Cross) already cut our telemedicine reimbursement to 85% of office payment, but I am always happy to give self-pays a bigger break.
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