HERE IS WHAT HEALTH INSURANCE COMPANIES ARE DOING TO DOCTORS.

Back four months ago I underwent a colonoscopy and upper GI endoscopy at Flagler hospital. Just yesterday I received the so called “explanation of benefit” from my insurance company which is basically a breakdown of what they paid. I was basically blown away by how little health insurance companies are paying physicians for their work.

To start with, I am a high-risk patient due to my prior history of septicemia, open heart surgery with valve replacement, high blood pressure and kidney cancer.

There were three physicians involved in my care, one an Anesthesiologist, one a Pathologist, and one a Gastroenterologist. Additionally, there was a CRNA, the Procedure room tech and nurse, the recovery room nurse and the nurse in the holding/admitting area.

Here is the brake down of payments: the Anesthesiologist and the nurse anesthetist got paid $79.47 to split between them. Just for comparison I hired someone just the other day to reconnect just one downspout from my roof gutter and he charged me $200.

Next was the Pathologist who examined the biopsy specimen to determine if it was benign or malignant. He got paid $213. And the other doctor, the one who performed the actual colonoscopy and upper GI endoscopy, she got paid $269.97. So, the payment to three medical doctors and one nurse anesthetist was a grand total of $562.82!

Now an additional $1584.53 went to the hospital for three nurses and a tech and the equipment use. The total paid by the insurance company for my care was $2147.35. Of which less than 1/3 or 26.2% of the total went to the three physicians and the CRNA which were the ones performing the specialized care and 73.8% to the hospital!

Now here is another comparison. The guy who I hired recently to varnish my home front door, paint the garage door, connect the above-mentioned downspout, and replace two small pieces of soffit is costing me $2750!

Now what does all the facts exposed here tells us? Us doctors have to tell insurance companies to go fly a kite and not let them exploit us paying us peanuts!

If you dont beleive me, when you get the explanation pf benefits from your health insurance company, analyze it and see what your doctor is getting paid after 12 years of education including college, medical school and training. And health insurance executives and hospital executives with less than 1/3 the education have huge salaries, benefits and golden parachutes at retirement!

4 Comments

Oct 3, 2024, 10:03:33 PM

Edward Dieguez - We need unity

Oct 3, 2024, 10:01:45 PM

Edward Dieguez - We need unity in our profession

Sep 18, 2024, 7:13:45 PM

Robert L. Griffin - Very Ridiculous but true. And the longer we keep accepting it, the longer they will continue to give us the shaft.

Sep 18, 2024, 11:27:37 AM

ROBERT L GRIFFIN - Ridiculous

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