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Some doctors switching to cash only payments

post #1 of 4
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post #2 of 4
I can really understand why some doctors want to do business this way and eliminate dealing with insurance companies, and I know there are a lot of arguements between doctors and insurance companies over how to provide the best care for the patient.

A few years ago a friend of mine was having female problems and constant bleeding, and I think this was continuing even after my friend had a D & C. My friend went to the doctor and was told her uterus needed to be surgerically removed...the insurance company didn't feel surgery was necessary and said they wouldn't pay for it. This company continued to interfere, argue repeatedly with the doctor, and prevent my friend from having medically necessary surgery for months, and while all this was going on my friend kept feeling weaker and sicker. Finally the insurance company gave in and agreed to pay for the surgery, and by that time my friend's uterus was in such poor physical condition that it completely fell apart when the doctor tried to remove it during the operation.
post #3 of 4
Well your friend could sue the insurance company. A bunch of decisions are coming up with regards to this issue. Currently only 10 states have passed laws that allow patient to sue their HMO.

Aetna Health Inc. v. Davila
Patient forced to take cheaper drugs than the one recommended by the doctor and suffered internal bleeding.

Cigna Healthcare of Texas v. Calad
HMO only willing to pay for one day of recovery after hysterectomy surgery despite the doctor wanting more and suffered from medical complications as a result.

So if your friend is still within the limitation period why not ask her to join in and perhaps help change the law.
post #4 of 4
Speaking as someone who has to deal with insurance companies as a provider of services, I do not blame the MDs at all for charging cash. My best psychological associate is quitting because she can no longer afford to practice -- she simply cannot get the insurance companies to pay her for her services. She spends many hours each week on the phone with these companies or filling out the exact same claim form for the umpteenth time -- time in which she could be seeing clients. The companies owe her thousands of dollars and she is to the point where she can't pay the mortgage on her house because she is working full-time but not being paid. The community is losing an amazing psychotherapist because she can't earn a living despite working full time.

Not to mention the fact that she is having no luck getting clients to pay their co-pays.
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