Both my husband and I saw Dr. Lagrelius for almost 5 years and both paid the concierge fee for 1 year. For the proposed benefits, it sounded great. Unfortunately, it was not great at all. Just don’t assume because someone promised to provide certain benefits that it will happen, even if you pay money.

I am sure I needed surgery for over 3 years and went undiagnosed. As for my husband, he was referred out to two different doctors who really let us down. We should have seen as attorney but I don’t have time to waste, just beware.

sorry…but we have had excellent PPO coverage for many many years…and NEVER has the provider,,xray..labs etc…been reimbursed at what the bill indicated…as I said…mostly it was in the neighborhood of 60% of the bill..and here in Calif…insurance companies use the same stats as Medicare…so reimbursement is the same …

here..those docs who go to conciege in most cases do NOT take non coniege patients..thus the $5000 or more per year..yes they do bill insurance

recently we had dinner with a 60 year old ENT friend…he says he is “making” less than 50% LESS than he did 20 years ago (no..his rates have not gone up..but his reimbursement has tanked)..for instance…for a tonsillectomy he now LOSES money..as he get $100 per..takes him away from his office minimum of one+ hour..during which time he could do 3 consults..etc…he is thinking of NOT doing tonsils anymore

as for the gov’t bailing us out…HAH..while I surely feel that healthcare is a RIGHT not a privilege…universal health care will likely throw us into the pool with countries such as Canada,,and England….long long waits for NON emergent care..and all kinds of rationing…etc..not that we here should be doing open hearts and transplants on those whose lifespan is at best 10 years…but Americans will not tolerate such…

as for costs for copying files etc…don’t know where you have been..but this has been common for as long as I have been an NP…owning your records,,HIPPA etc does not mean the providers etc have to pay for the paper,,clerical time etc…

so glad I am old and retired…tho I just found out that when I turn 65 in June…my Medicare will cost me 94 a month…and my supplemental (PPO>>no meds) will add at least another 150 a month

good luck

rosemarie

Thankfully, we haven’t had extensive hospital stays or surgery (knock on wood!), and my doctor really has been reimbursed for what we’ve been charged. I know that a lot of insurance places don’t cover the full cost. I’m not sure who is to blame for the price of the charges: malpractice insurance rates, overcharging by doctors and hospitals, or underpayment by insurance companies. I have a feeling there is a lot of finger pointing in that Catch-22.

But, like I said, my point was I’m not going to be forced to pay for a service I can get somewhere else for what I’m already paying. That’s the bottom line for us. I worry about the people who don’t have good doctors to choose when they’re put into this same situation…

Thanks again for the comment!

in what world is that

I have excellent PPO coverage..for me..hubby is on Medicare thank god..

my doc is lucky to get about 60% of the “usual and customary” charge..and he is in network..

ever had surgery?? hubby’s CABG hospital bill ALONE (not counting docs anesthesia..etc) was $60,000 or so…hospital got a measly $14,000 since they “accepted assignment)…we were not billed for the difference

sorry…them’s the facts..at least here

rosemarie b

http://talk.milehighmamas.com/viewtopic.php?p=644506#p644506.

I have seen our doctor’s bills, and the insurance matches what he’s charged. Like I said, we have excellent coverage. I know not all insurance coverage is the same.

Interestingly enough, one of my close friends lives in a different city in Colorado, and she said her doctor recently went to a concierge practice, only that doctor said her practice wasn’t for those who are healthy and only see the doctor on rare occasions (like my husband and I do…we’re healthy and only see him for our annual exams and if there’s a situation that has arisen…we’re not chronically ill), and the doctor encouraged her to find a different practice. Thankfully, we have choices and options here.

I think we all agree that the system(s) are broken.

Thanks again for commenting! I love hearing everyone’s perspectives!

as for the comment that “my doctor is already reimbursed handsomely”…perhaps next time you get an EOB you need to compare what your doc is getting…usually it is a pittance of his charges..

just an opinion…this was bound to come..for both the docs who don’t want to see 4+ patients per hour…and the patients who are willing to pay for better attention

The reality is that our insurance is what it is. This doctor is trying to charge us extra for something that he’s already (and should be) providing.

To me, it’s as if we’ve already paid for our plane tickets, but now the Pilot has sent us a letter telling us that we can’t fly on his particular plane until we pay a Membership Fee. With this fee, he will personally see to it that we have seats on the plane. He will take off and land the plane appropriately. He’ll be sure he goes to the correct airport. As premium members, he will see that we also receive a tasty beverage. We can also have his cellphone number if we have any questions.

See what I mean? When I get on a plane I expect to have a seat. I expect it to go to the correct airport and for it to take off and land properly. I bought the tickets! That comes with the price of a ticket!

I don’t really need to fly on HIS plane. I’ve purchased the tickets, so I’ll fly with a pilot that doesn’t charge me extra.

Again, thanks for the comment! These systems are definitely broken, and I don’t know how to fix them either. We’re just along for the ride.