Re: Medicaid and Insurance
From: rchudacoff (rchudacoff@mylinuxisp.com)
Sun Jul 18 09:33:49 2004
Well, at 35 weeks I suck it up. But before that THEY were the ones who
changed the contract of care, not me.
Richard Chudacoff, MD
>---------- Original Message -----------
From: "Geff Klein" <gyndok@yahoo.com>
To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
Sent: Fri, 16 Jul 2004 17:00:40 -0500
Subject: Re: Medicaid and Insurance
> Could the patient accuse you of abandonment?
>
> Geffrey H Klein, MD
> 450 Blossom Suite C
> Webster, Tx 77598
> 832 553 5430
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
> Richard Chudacoff, MD
> Sent: Friday, July 16, 2004 2:54 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: RE: Medicaid and Insurance
>
> Geff
>
> I know this well. My solution: if you start with me as an insurance
> patient, I will not continue to take you as a patient if you switch
> to Medicaid. If you start as a self-pay and pay per visit as
> appropriate, I will not continue to take you as a patient if you
> switch to Medicaid. Lastly, if you switch Medicaid plans mid-
> pregnancy, I will not continue to take you as a patient.
>
> I just don't plan to make this payment game any harder than it is
> already.
>
> ECON 101, as found in The Godfather: it's nothing personal; it's just
> business.
>
> Richard Chudacoff, MD
>
> Beer is living proof that God loves us and wants us to be happy.
>
> <http://www.brainyquote.com/quotes/quotes/b/benjaminfr109859.html>
> Benjamin Franklin
>
> Heaven grant that the burden you carry may have as easy an exit as it
> had an entrance.
> [Prayer To A Pregnant Woman]
> - <http://www.brainyquote.com/quotes/quotes/d/desiderius148996.html>
> Desiderius Erasmus
>
> _____
>
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
> Geff Klein Sent: Friday, July 16, 2004 12:21 PM To: Multiple
> recipients of list OB-GYN-L Subject: OB: Medicaid and Insurance
>
> Has anyone else had this problem lately?
>
> I am having a rash of patients who present for their first pregnancy
> visit with health insurance. Then at some point during the pregnancy
> they drop the insurance and get on Medicaid. They generally do this
> as they become aware of the large out of pocket expenses associated with
> continuing as an insured patient.
>
> The problem is that now I had been providing services under a global
> fee and had not collected anything other than an OB deposit. Now I
> am obligated to refund this to her. In addition Medicaid reimbursement
> is substantially less than I would have otherwise gotten for her
> care. I am also now subsidizing her care with my tax dollars.
>
> The insurance company must love this. They have collected premiums and
> will now not have to pay for the delivery. If I were a conspiracy
> theorist, I would suggest that insurance companies intentionally have
> designed the system to force patients into this type of behavior.
>
> The patient is ok with it if she will not have any out of pocket
> expenses.
>
> I, however, take a big hit. If one or two patients did this it
> would have little impact on revenue. However, it is getting to be almost
> epidemic in scope. If it continues, it could very well endanger the
> ability of my practice to sustain itself. (in addition to the rising
> overhead and overall lower reimbursement).
>
> My feeling is that this really is fraudulent. Public assistance is for
> folks without resources, not for people who don't feel like paying
> medical bills. There really should be some sort of regulation
> against this type of maneuvering. It is costly for the public and
> wastes tax dollars. It is harmful for medical practices. I say
> that patients should not qualify for Medicaid if they have
> voluntarily discontinued their insurance during pregnancy.
>
> Has anyone else encountered this? How are you dealing with it?
>
> Geffrey H Klein, MD
> 450 Blossom Suite C
> Webster, Tx 77598
> 832 553 5430
------- End of Original Message -------
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