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me_irl (lemmy.world)
submitted 1 year ago by to c/me_irl@lemmy.world
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[–] 9 points 1 year ago (10 children)

From his perspective, that makes a kind of sense. He can probably bill an extra fixed fee for a particular service code if he asks the questions. And the insurance company is willing to pay because they think I'd they get stuff treated earlier with cheaper methods, they save money in the long run.

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  • [–] 8 points 1 year ago (9 children)

    Is that how it works?

    That only makes sense if you disregard the uninsured.

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  • [–] 22 points 1 year ago (4 children)

    You also don’t always want to be honest at the doctors. If you change the appointment from preventative to diagnostic by asking the wrong question, suddenly it can go from zero dollars to $200 depending on your plan.

    Ask me how I know. Unfortunately, it’s not really a place I feel like I can be honest.

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  • [–] 6 points 1 year ago (3 children)

    It's BS that physicals are preventative and free but they're the only appointments where they do blood work that isn't free. Insurance typically covers physicals entirely because they're preventative. Why the lab work that is part of that preventative assessment isn't free is beyond me.

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  • [–] 4 points 1 year ago (2 children)

    That and what the person you're replying to about choosing your words carefully is insane. I was speaking with a rep from my insurance trying to figure out what I need to do for the free annual physical checkup stuff and they were telling me how I should speak to the doctor to avoid getting charged a consultation fee (i.e. don't ask questions, avoid answering if they ask something about your current health, emphasize that you're only there for your annual physicals, etc.). And if you don't have a PCP, you probably have to pay for the visit either way as a "first-time patient" just to get the doctor's orders for your labs. It's bonkers navigating the system.

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  • [–] 6 points 1 year ago

    This is based on my experience in the United States with employer-based group health insurance. Obamacare aka the Affordable Care Act required those types of insurers to cover more mental health services. As a result, they are keenly interested in funneling people into outpatient services instead of impatient, which is probably a good thing in the abstract.

    Many of these employer-insurance people are on PPO-style plans, which are supposed to have big networks where you can see roughly any doctor you want, and don't need a referral to go to a specialist. Those types of plans don't have a lot of levers to influence the behavior of their insured clients to good health outcomes.

    So that's where the "depression questionnaire" comes in. The insurer can pay the primary care physician 15 or 30 dollars to ask a short series of easy questions to screen for a common behavioral health disorder that drives claims. Somebody published a paper that says that this short series of questions is effective at detecting depression (or whatever). Therefore, if we give everyone these questions, and get a few more people into outpatient therapy options than before, we're both saving money and improving public health outcomes, right?

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  • [–] 5 points 1 year ago (1 child)

    Only ER doctors see uninsured people in my area.

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  • [–] 2 points 1 year ago*

    Don't forget, it's part of the local cops' jobs to sweep away the homeless houseless from one rich neighborhood to a less-rich one, and on down the line, ad nauseum. They're the largest, most visible population that almost no one sees. 🤌🏼

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  • [–] 4 points 1 year ago

    Yes, it's literally a pointless cash-grab that they can bill to insurance.

    Last time I was at my primary care, I was handed a survey as part of my pre-appointment paperwork. I started filling it out before I read the fine print at the end: It was optional. It would be billed to my insurance, and "most patients'" insurance covered the charge. I refused to complete it. Just one more tiny outrage as part of the massive scam that is the American medical system.

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