Re: cesarean on demand

From: Garry E. Siegel, M.D. (garrys@mindspring.com)
Fri Dec 30 09:49:07 2005


Lynn:

Of course, you can't balance bill for Medicaid.

If a Medicaid patient goes for a breast augmentation, I have to think it is OK for the surgeon to bill her/have her pay up front, as that is non-covered.

Why would this be different?

That said, the simplest thing (and maybe best from a global picture including liability, ease, and keeping the patient happy) is to do it. Whether you want to try to argue about "maternal anxiety," get a second opinion, etc. is another story.

Garry

At Fri, 30 Dec 2005, Lynn D. Montgomery, M.D. wrote: >
>Thank you for all the responses, but there is a major point being missed.
>In Montana, as a Medicaid participant, I am not allowed to balance bill
>anything. Reimbursement for pregnancy is global, therefore given they will
>not pay for an unindicated procedure, they will pay for a standard prenatal
>care, delivery and postpartum care. If the patient comes in within 30 days
>of her delivery date - particularly when she comes in in labor, I have to
>take care of her and cannot dismiss her.
>
>As such, I am stuck doing a cesarean and not getting paid for it.
>Lynn
>
>--
>Lynn D. Montgomery, M.D.
>Maternal-Fetal Medicine, OB/GYN
>Rocky Mountain Women's Health
>2835 Fort Missoula Rd., Suite 304
>Missoula, Montana, 59804
>406-549-0978
>fax 406-549-0987
>e-mail: apgar10@montanadsl.net
>

--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA




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