Originally Posted by
Dan Druff
John Mehaffey's recent experience with being forced to sign a form at a doctor's office promising not to give bad Yelp reviews reminded me of what a mess our healthcare system has become.
Mind you, socialized medicine would be even worse at this point (especially built on top of our existing system), but there are lots of clear flaws with our system.
Here are my suggestions regarding visits to healthcare providers:
- Check the reviews beforehand. Just google the doctor's name and the city he's in, with the word "reviews". If there are a number of credible-sounding bad reviews, don't go. People in general tend to give doctors better reviews than they deserve, so if you see a doctor with a lot of bad reviews, it's trouble.
- Double and triple check that they take your insurance. Check both your insurance company's website AND ask the doctor's office both on the phone and during your first visit. If it ends up that they don't take your insurance, YOU will be the one responsible, regardless of what the insurance website or your doctor's office said. Sad but true.
- Do not ever overpay now with the agreement that they'll refund the difference later. You will almost always get screwed this way. Only pay charges you agree are correct.
- In the event of a billing dispute, play hardball, and pretend you don't care about your credit. Maintain a tough stance that you absolutely won't send a penny above what you feel you owe, and that you won't even pay the existing bill at all until it's corrected. Never agree to send in a partial payment if the bill is incorrect. Your only power is your threat to withhold money entirely if they won't play ball.
- You can negotiate ER bills down. Try it.
- In the event a dispute can't be resolved, try calling your insurance company and asking them to make a one-time exception to pay the amount in dispute. They will sometimes agree to do this in order to solve the problem, especially if the amount of money is under $300.
- Always ask for the cash rate for expensive tests and procedures. They may be cheaper than doing it through your insurance, in which case, do not give your insurance info and just pay cash.
- Never give your social security number to a doctor or healthcare facility for any reason. They don't need it. They want this for collection purposes. Don't fall for it.
- Avoid giving your workplace info to a doctor or healthcare facility for any reason. Same as above. They want this for collection and other legal purposes. Simply put "self employed", unless you're part of a work insurance plan, then you can put your employer down.
- Do not automatically agree to tests prescribed to you. They can be shockingly expensive, and sometimes dangerous and/or painful. Make sure you fully understand each test, its approximate cost, and the need for it. Provided your situation isn't urgent, go home and google this stuff.
- Never agree to surgery without at least a second opinion.
- See a doctor between the ages of 35-55, if possible. You want someone old enough to have experience, yet young enough to be open to new discoveries and new ideas. You also want their mind to be sharp. Especially avoid doctors over 70.
- Do not see a D.O. or foreign-educated doctor. Usually these are doctors who were American-born but could not get into US medical school. If you are sure that they are foreign-born and went to a respected foreign medical school, then this doesn't apply.
- Do not ever go to an office with a bad reputation for scamming or major billing issues. Yes, it will happen to you, too.
- Attempt to figure out which specialist you need, and then go directly to that specialist, if your insurance allows it.
- Avoid using Urgent Care unless it's for something minor and/or simple. The nut low doctors work there.
- Always sanity check any diagnosis by looking everything up on the internet after-the-fact. If it really seems your doctor is wrong, he/she probably is.
- Be aware that many doctors will attempt to give a diagnosis and treatment, even if your symptoms reveal nothing specific. This is because most patients hate inaction. Don't fall into this trap. If you have something difficult to diagnose, such as abdominal pain, don't let the doctor just guess at something and make that your diagnosis. Ask them how certain they are, and then sanity check it yourself.
- Do not use an office which makes you see a nurse practitioner or physician's assistant in place of the doctor. For small things, this is fine, but if this is their common practice, find a different doctor.
- If getting a "free" annual physical, do not ask any questions of the doctor, and do not bring up any other health concerns. This will allow them to bill you for one or more items, even if the discussion lasts 10 seconds. In fact, state at the beginning of the physical (to the scheduler) that you don't want any additional charges, and that you want the free annual physical, and nothing else.
- Be more skeptical of the doctor wanting you to do tests or procedures at their office. This is how they profit the most. If you're sent elsewhere for tests, still be skeptical, but the upside for the prescribing doctor is much less.