Thoughts on charging the same thing for a nurse practitioner as for a doctor...

[MinnieMe87]

Doctor of Osteopathic Medicine They are Dr, just with a little bit of a different training.

Thank you for clearing that up! I thought they were, but then thought maybe the abbreviation you had put meant something different that I wasn't aware of! LOL

No, your preference is to be seen when you want to be seen by whomever is available otherwise you would have waited 2 months for the doctor. You didn't want to wait.

You accepted the nurse practitioner appointment therefore you (or your insurance) will pay what the nurse practitioner requires you to pay. It's that simple. You don't get to say what someone's time is worth, you only get to decide if you wish to pay it or not- BEFORE you take the service.

It is your responsibility to inquire how much a service or item is going to cost before you purchase it.

This is why many nurse practitioners will not see physician overflow patients, the patient can either wait for their own doctor to have an opening or they can go elsewhere.

Having said that, those who are insinuating that nurse practitioners are the same as doctors, that's wrong. Nurse practitioners are not the same as doctors anymore than an LPN is the same as a nurse practitioner. Each has their own training and skill set.

Amen!!

 

[Allison]

The doctor's office has nothing to do with your co-pay. It's the insurance company and they obviously aren't using the tiered method you mention. I've never seen that myself.

 

[Acklander]

The co-pay is what the insurance states, not the Dr's office. It would only bother me if, for some reason they weren't able to help me and I had to make a second appt with the Dr., causing a 2nd co-pay to have to be paid.

 

[OceanAnnie]

No, your preference is to be seen when you want to be seen by whomever is available otherwise you would have waited 2 months for the doctor. You didn't want to wait.

You accepted the nurse practitioner appointment therefore you (or your insurance) will pay what the nurse practitioner requires you to pay. It's that simple. You don't get to say what someone's time is worth, you only get to decide if you wish to pay it or not- BEFORE you take the service.

It is your responsibility to inquire how much a service or item is going to cost before you purchase it.

This is why many nurse practitioners will not see physician overflow patients, the patient can either wait for their own doctor to have an opening or they can go elsewhere.

Having said that, those who are insinuating that nurse practitioners are the same as doctors, that's wrong. Nurse practitioners are not the same as doctors anymore than an LPN is the same as a nurse practitioner. Each has their own training and skill set.

You are right. I did choose to see the N.P. over not being seen at all in a timely manner.

And you are right again about the pay. Of course that's why I didn't say anything. I knew that. I don't get to choose the pay scale. Thus it is a question on a message board.

And lastly, your last comment was the premise of my question in the first place.

 

[AshleyW]

Having said that, those who are insinuating that nurse practitioners are the same as doctors, that's wrong. Nurse practitioners are not the same as doctors anymore than an LPN is the same as a nurse practitioner. Each has their own training and skill set.

I don't completely agree with that. In many places, an NP can practice just as an MD can. They can write prescriptions, they can order tests.. yes, they have different education paths, but for the average person, it doesn't really matter if you see an NP or an MD.

 

[CanBeGrumpy]

This doesn't really address the original question, but if your doctor is making you wait 2 months for an appointment (assuming your issue is somewhat urgent), then what good is that doctor to you? I once had a doctor like that--I called for an appointment for a severe ear ache, and they told me it would be 7 weeks before I could be seen! Uh, sorry, you are no good to me, bye bye!!

I have recently found a doctor that blocks out nearly half his day for "same-day" appointments, and he told me that if I ever call and cannot get a same-day appointment, I am to tell the receptionist to have the doctor call me, and he will set things straight. OP, you need to ditch Dr. Two Months and find someone else!! Seriously, what good is a doctor that can't see a patient for 2 months? I can see a long wait for a yearly physical, but not for an actual medical problem!

 

[OceanAnnie]

This doesn't really address the original question, but if your doctor is making you wait 2 months for an appointment (assuming your issue is somewhat urgent), then what good is that doctor to you? I once had a doctor like that--I called for an appointment for a severe ear ache, and they told me it would be 7 weeks before I could be seen! Uh, sorry, you are no good to me, bye bye!!

I have recently found a doctor that blocks out nearly half his day for "same-day" appointments, and he told me that if I ever call and cannot get a same-day appointment, I am to tell the receptionist to have the doctor call me, and he will set things straight. OP, you need to ditch Dr. Two Months and find someone else!! Seriously, what good is a doctor that can't see a patient for 2 months? I can see a long wait for a yearly physical, but not for an actual medical problem!

My wonderful doctor that I loved recently retired. The 2 month delay was because actually I have an appt. in Feb for this 'new" doctor. It's to be a "first time" visit with a "new to me doctor". A problem developed and I couldn't be seen earlier. I don't know what the wait would be for a regular visit without the "new" status. You may be right. It might not be the doctor for me.

It's funny. I went from a one doctor office, never had a problem being seen, to this uber large practice (excellent word of mouth) and this happens right off the bat. Something to think about.

Thanks.

 

[Cindy F]

I don't completely agree with that. In many places, an NP can practice just as an MD can. They can write prescriptions, they can order tests.. yes, they have different education paths, but for the average person, it doesn't really matter if you see an NP or an MD.

Just because NPs provide excellent care in the field they are prepared does not mean they are "the same as doctors". It is illogical to think someone with 6-8 years of education is "the same" as someone with 10-12 years of education. If they were the same as doctors, they would have the same degree and scope of practice. As far as whether it matters or not which one you see, that depends on the patient's needs.

I have heard this same argument in regards to LPNs that are "just the same as RNs". No, they are not.

It is just as wrong to diminish the physician's educational accomplishments as it is to belittle the nurse practitioner's.

 

[chloelovesdisney]

Your copay may be the same, but the charge to the insurance company will probably be less. A NP program is half the time of medical school, plus a NP doesn't go through a four year or so (depending on the speciality) residency. The NP school and clinical is completed during the same time period.

Another thing to consider is that it is very competitive to get into medical school. The requirements are much tougher for admission. I'm an RN and half my friends are either NP's, CRNA's or in school for one or the other. None of them had a hard time getting into a program at all.

NP's can write presciptions and order tests, but you'll never find a NP heart surgeon for instance, because they don't have the same educational backround or clinical experience. I will see a NP for a simple check up, but for a more serious issue or concern, I want the doctor.

I believe that a longer education program plus residency results in a better qualified practioner which yes, I am willing to pay more for. So I agree somewhat with the OP, that the doctor should cost more than the NP. The copay is always the same though.

 

[AshleyW]

Your copay may be the same, but the charge to the insurance company will probably be less. A NP program is half the time of medical school, plus a NP doesn't go through a four year or so (depending on the speciality) residency. The NP school and clinical is completed during the same time period.

Another thing to consider is that it is very competitive to get into medical school. The requirements are much tougher for admission. I'm an RN and half my friends are either NP's, CRNA's or in school for one or the other. None of them had a hard time getting into a program at all.

NP's can write presciptions and order tests, but you'll never find a NP heart surgeon for instance, because they don't have the same educational backround or clinical experience. I will see a NP for a simple check up, but for a more serious issue or concern, I want the doctor.

I believe that a longer education program plus residency results in a better qualified practioner which yes, I am willing to pay more for. So I agree somewhat with the OP, that the doctor should cost more than the NP. The copay is always the same though.

Of course. No one is arguing that (the bolded). For most issues, an NP and an MD are interchangeable. If you have a sinus infection or strep throat, then it doesn't really matter if you get an NP or an MD, does it? For more serious issues, yes, you would want to see an MD or a specialist. Just like if you go to your MD PCP with blinding headaches, you'll get referred to a neurologist - someone who has more experience.

 

[justhat]

I do see your point. I don't think anything can be done about it insurance-wise, but I don't think you were asking that anyway.

NPs are simply not the same as drs. They may function as such in a dr's office, but cannot open their own clinics and function independently in many states. Some states do not allow them to write prescriptions on their own, it has to be under a physician. They do have greater training than an RN, such as a masters degree, and can specialize in things as well. But the training isn't quite as extensive as a physician, who has 4 years of college, then 4 years of medical school, then a minimum of 3 years in residency (could be as many as 8 years), possibly a fellowship for 1-2 years post-residency. They are then allowed to practice on their own as full physicians, after quite a bit more training than an NP.

NPs can be very nice, informed, experienced, etc. I have seen the one at my OB's office when I had double mastitis and needed an appt that day and I called at 3pm. It was the NP or wait till the next day. The NP was fine with me. And she would be fine with me for regular gyn visits as well, though I do see my regular OB for those, simply because I've been seeing him for over 6 years now.

My daughter also saw one as a baby, but that experience did not go so well. She was 6 weeks old and had a pink, crusty eye. I stopped in at the ped's after my OB well check, since it is next door, to be sure the ointment we were prescribed the previous Friday was in fact appropriate and that it was pink eye, not a blocked duct. The ped had mentioned it could be either, but since we had been around another kid with pink eye she gave us the ointment. Since I didn't have an appt I was seen by the NP since all the drs were full. She looked at my daughter's eyes and panicked, thought she saw a tumor, had me call from there to get an appt with the pediatric opthamologist for the next day, and needless to say I was in a true panic. I thought my newborn had cancer and spent 24 hours in a state of fear. Well, the pediatric eye dr looked at her eye and knew immediately that the haze the NP had seen was just a result of the blocked duct.

I appreciated the immense concern of the NP, but man, to hear something like that with your 6 week old baby is scary! That's not to say the ped couldn't have made the same mistake, but the ped did see my daughter a few days earlier, looked at her eyes, and did not make any mention of a possible tumor. Could have just been a coincidence, or it could have been that the ped had more training and/or experience.


ETA: Chloe and Cindy said what I was thinking in more eloquent ways.

 

[Jestocost]

The co-pay also is the same if you see a doctor for a routine matter that takes 10 minutes or a for a complicated consultation. That's more the parallel I see. the charge to the insurance may be different for one vs. the other, but the co-pay will be the same.

 

[chloelovesdisney]

I don't think of a MD as only an internist or general practioner, but if you are comparing NP's to those specifically you will get the same treatments for something such as strep throat. My concern would be if what was thought to be a straightforward case of strep throat wasn't. I think a MD is more likely to be aware of more rare problems and recognize them.

I would never say that a NP and MD is interchangeable. Two years of school is not the same as four, and an intense multiyear residency compared to zero years of residency cannot produce the same interchangeable results.

NP's serve a good purpose and can do a great job, but I would never say that they are the same as a doctor.

 

[justhat]

Chloe mentions a very good point. Also, it doesn't seem as though the OP was seeing the NP at her GP's office. Maybe she was, but I am thinking it was a specialist's office.

 

[Keli]

I think if it is costing my insurance less when I see the np then it should cost me less as well.
Actually we have a np at my dr's office and I prob won't see her again. Saw her once and athough she asked more questions than my dr usually does she provided a lot less answers to my questions. I left feeling like she didn't get to the root of my medical problem because she lacked the education/experience to do so.

 

[MIGrandma]

I have never really thought about it.

I see the PA-C (physician's assistant? or is that the same as a nurse practitioner? I'm not sure) most of the time instead of the doctor. If I'm really sick, and don't know what's wrong (not the flu, or back problems, etc. but like the time I was having trouble breathing) I will try to see the regular doctor. But for things like my diabetic check-up, or my yearly physical and pap test I don't mind seeing the PA-C.

I don't have a co-pay, we pay doctor visits out of our own pocket. I've never even thought to ask if there is a different pay scale when seeing the PA-C as opposed to seeing the regular doctor. Might be worth asking tho.

 

[DebbieB]

What I hate is you get charged another co-pay for follow-up visits. One time I had my annual gyn visit, got a call about a week later that there was a problem with my pap test, there were no cells on the slide. I had to pay my co-pay again to get it redone! That seemed very unfair! Then last year my doctor recommended a test. I had the test done and the office asked me to come in for the doctor to discuss the results, even though the test did not indicate any problems and could have been discussed over the phone. I got hit with the co-pay again!

 

[lewdyan1]

I think if it is costing my insurance less when I see the np then it should cost me less as well.
Actually we have a np at my dr's office and I prob won't see her again. Saw her once and athough she asked more questions than my dr usually does she provided a lot less answers to my questions. I left feeling like she didn't get to the root of my medical problem because she lacked the education/experience to do so.

This is how I feel exactly. The past two visits have been with the NP and she just didn't have the experience/knowledge to answer my problems and referred me to come back and see the doctor (both times) and then had to pay the co-pay twice... Now I only book when the doctor is available...

 

[Stacerita]

What I hate is you get charged another co-pay for follow-up visits. One time I had my annual gyn visit, got a call about a week later that there was a problem with my pap test, there were no cells on the slide. I had to pay my co-pay again to get it redone! That seemed very unfair! Then last year my doctor recommended a test. I had the test done and the office asked me to come in for the doctor to discuss the results, even though the test did not indicate any problems and could have been discussed over the phone. I got hit with the co-pay again!

I would have questioned the office about that. A few years back I was extremely ill and needed to go to the office every 3 days to check my levels and such. He charged me my co pay on every 5 visit or so.

The insurance being charged differently for the NP and the MD is understandable. But for the co pay, I usually associate that with everything that goes into my having a visit at the office. The paper work, the office time, etc. I wouldn't balk at having to pay the same copay to see the NP.

 

[DebbieB]

I would have questioned the office about that. A few years back I was extremely ill and needed to go to the office every 3 days to check my levels and such. He charged me my co pay on every 5 visit or so.

The insurance being charged differently for the NP and the MD is understandable. But for the co pay, I usually associate that with everything that goes into my having a visit at the office. The paper work, the office time, etc. I wouldn't balk at having to pay the same copay to see the NP.

I did question it, they said it was up to the insurance company. I refused to pay it until the insurance company sent the EOB and I even called them to question it.