Posted by JennyR on July 1, 2000, at 16:44:15
I'm wondering if this is typical, or lousy.
My pdoc is dropping our insurance. I currently see him every 2 months for a $10 co-pay. He says our insurance doesn't pay him enough and he doesn't like the paperwork and hassles. He gets $50 for the 15 minutes from them, and privately he gets $125. He said he's willing to keep me if I pay $50. There are other providers who take my insurance that I could switch to, but I was just wondering, does this seem unprofessional or unkind of him, or just typical. It's not the first time he's mentioned money and not being happy with what insurance pays him.
He also lied to me once when I started seeing on the insurance statements that he was submitting it as psychotherapy instead of medication management. I asked him about it, since I am in therapy elsewhere and only see him for meds. He said some clerk at the insurance company must be putting the wrong code on. He also said, which contradicted that, that the code for medication management only allows for 5 minutes and he spends 15 with me, so he feels entitled to the rate for the psychotherapy code. I found out that it is he who puts the code on, and that it is 15 minutes, not 5, that is the time allotted for the medication management code. When I brought it up to him, I was calling to say there was a problem with the dosage, I also mentioned this and that it bothered me that he had said these things which I know to be untrue. He got very defensive and said "and how many minutes are we spending talking now that I don't get paid for?" I got kind of upset. He then called me back and said he has a memo from the insurance company saying he can use that code and he can FAX it to me to prove it. I told him that wasn't the point, that he had said a clerk at the insurance company was putting the code on, which wasn't true, and that also I know the description for the med management is 15 minutes and he kept saying only 5. He then said "let me look it up, oh yes, it is 15 minutes. Well, I'm sorry for any misunderstandings and I hope we can continue to work together." I stayed with him because he knows meds. I also always thought it was weird that he talks about himself a lot. Tells me what amusement parks he takes his kids to, what trips they take, how his wife feels about where they live, etc. All without my asking.
Anyway, now he's dropping me and others. Unless I want to pay more. Is this ethical?
poster:JennyR
thread:38975
URL: http://www.dr-bob.org/babble/20000630/msgs/38975.html