Does your health insurance company offer a cash or cash like rewards program?

[kimblebee]

No that is the actual definition of a 99214. However, doctors in his area are charging a rediculous amount for that 99214. I work in specialty office (that can charge more than a family practitioner or internal med doctor) and a 99214 is about $300 total. Our most expensive code (not including procedures) is a 99205 for a super complicated new patient and for that we charge about $495.

I get that it’s real and not trolling. I just can’t wrap my head around it.

 

[MrsJackSparrow4Life]

I get that it’s real and not trolling. I just can’t wrap my head around it.

It is better than what insurance companies are trying to get it switched to, which is a fee for outcome model. Doctors pay will be based on whether patients get better or not. Example being a diabetic patient’s A1c gets below a certain number. It sounds like a good idea until you take in account how many non-compliant patients there are.

 

[tvguy]

It is better than what insurance companies are trying to get it switched to, which is a fee for outcome model. Doctors pay will be based on whether patients get better or not. Example being a diabetic patient’s A1c gets below a certain number. It sounds like a good idea until you take in account how many non-compliant patients there are.

Our healthcare and health insurance systems are an extreme mix of life saving care and business. IMHO we haven't arrived yet in finding a balance.

We have efforts to switch to outcome based compensation.
We have concierge medicine (also known as boutique medicine, retainer-fee practice, direct care, and membership medicine) where you pay a Doctor an additional $125 a month or so for better service. Sort of like Disneyland Maxpass for medical care.
We have health exchanges for those who can't get insurance.
We have tax penalties for those who can't afford health insurance even after subsidies (and can't afford the penalty either) and those who say they don't want health insurance.

 

[ImprovGal]

LOL. Trolling? Google Medical Code 99214. This is the code in the universal code system every Doctor and every Insurance company in the country uses to determine payment. I didn't make it up. Does it make sense? I don't know, but both sides have agreed to this system.

I do know from my neighbor, who worked for insurance companies auditing codes that Doctors billed, that Doctors do tend to over estimate what they did. She said in a typical year she found about $5 million worth of over coding. So you are not alone in your opinion.

There are a few different codes for Office visits for an established patient, 99211 - 99215. Unless you've got a lot going on with your health that was addressed at this visit, I'd be concerned your dr may be upcoding for additional revenue.

 

[MrsJackSparrow4Life]

He said he sees an internal Medicine doctor so there probably was a lot discussed at the visit.

 

[Hikergirl]

We get $1600 put in to our HSA if we do a bunch of stuff, plus we earn points we can redeem for merchandise like Apple Watch or fitbits

However by making up for this they have now changed to in network coverage only.

 

[tvguy]

There are a few different codes for Office visits for an established patient, 99211 - 99215. Unless you've got a lot going on with your health that was addressed at this visit, I'd be concerned your dr may be upcoding for additional revenue.

High blood pressure controlled with medicine.. A1C was in the area where I was at risk of Type 2 diabetes. Medicine, diet and exercise have kept that in check. 10 minutes with the Doctor twice a year after blood work to check blood pressure, and go over test results. I would think the insurance company would question the code if they felt it was upcoded. And we have new insurance this year, so that may change.

 

[ImprovGal]

High blood pressure controlled with medicine.. A1C was in the area where I was at risk of Type 2 diabetes. Medicine, diet and exercise have kept that in check. 10 minutes with the Doctor twice a year after blood work to check blood pressure, and go over test results. I would think the insurance company would question the code if they felt it was upcoded. And we have new insurance this year, so that may change.

You are entitled to question the charge. Otherwise upcoding may not stand out unless it's a pattern and the provider's distribution of office visits looks markedly different from that of its peers.

 

[tvguy]

You are entitled to question the charge. Otherwise upcoding may not stand out unless it's a pattern and the provider's distribution of office visits looks markedly different from that of its peers.

I have an appointment next month. I'll see how our new insurance handles this code. But just asking around here at work this morning, what I am paying is in line with what others are paying.

 

[GreatLakes]

We get free gym memberships, forums access to ask nurses questions, and some other perks. We also have the ability to lower our out of pocket monthly premiums by up to 40% if we are tobacco free, participate in a yearly health checks and blood work with our doctors, and meet with a health coach quarterly.

There is no "lose this much weight and get $x" program but what we do have is pretty nice.

 

[kdonnel]

There is no "lose this much weight and get $x" program but what we do have is pretty nice.

Ours started with programs like that 5-7 years ago but it turned out there was very little participation.

The first year you had to have good numbers of the biometric screening to get the money. You got so much if your BP was fine, so much if you A1C was fine, so much if your BMI was fine, etc. The people who would benefit most from knowing their biometric results didn't participate because they would not get any cash.

Every subsequent year the program has been geared more and more towards informing people about the state of their health and offering up small simple ways they can improve their health rewarding them for just paying attention.

 

[mrodgers]

I get a discount on the biweekly premium if I watch videos for smoking cessation (I don't smoke, but chew snuff. Not proud, but I'll be honest.) You're good just watching the videos until next year, or just lie and tell them you quit.

Another discount on the premium if I jump through a bunch of hoops. They can't keep the hoops straight and I've yet to get that discount in 3 years even though I jumped through them all. I quit jumping last year.

Every quarter if you watch a bunch of videos and record some kind of exercise activity, you earn a $50 gift card. They are for Walmart or our local grocery store, which you then can buy gift cards or Visa/MC cards and earn money off gas. I get the Giant Eagle cards, then buy Amazon cards with it, get money off gas and buy all my cycling and camping stuff for nothing.