Friday, September 7, 2012

Primary Care Payment Struggles

The way doctors bill and get paid is a byzantine process and it is no wonder the "private practice" doctor is an endangered species.  It takes a keen sense of business, a love of medicine-not money, and a sense of humor to survive.  Here is my latest story.  You can't make this stuff up....

I saw a patient in September 2001  (note the date...11 years ago).  I billed her insurance company, Employers Mutual, LLC for $185.00.  I never got paid.

Now fast forward to September 2012.  I received a document from an attorney who informs me that he is a receiver in a class action suit and $48 million in unpaid claims is being claimed.   It appears I am a Category B creditor and will receive a pro-rata share.  He recovered $16, 559, 576.88 and took $4,831,214.40 in attorney fees.

It looks like in the future (?) I may receive a check for $37.00.  No promises are given.

I remember my practice back in 2001.  I worked about 80 hours a week and never even had enough money to fund a retirement plan for myself.  Getting paid a fraction of my charges was common and getting stiffed by insurers completely was also par for the day.

 I am happy for the windfall of $37.00 for the work I did 11 years ago.  I still see patients in a private practice but my main income now comes from my employed administrative position.  Waiting 11 years for a fraction of payment is not a sustainable business model.


Michael Kirsch, M.D. said...

Congratulations on your unexpected bonanza! Will this move up retirement?

Toni Brayer, MD said...

Michael Kirsch: Ahhh, I can't retire yet. No check in hand and it might be another 11 years before the $37 arrives.

Anonymous said...

I read an article today that so many doctors are opting out of insurance completely and asking patients to pay up front. This is understandable after reading your column, but certainly will be a problem for the average American who still has to have insurance. What a mess we are in.

Toni Brayer, MD said...

Just thought I'd give an update on the $37.00 as of today, March 29, 2013. No check!

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