It Appears the Age of Obamacare Has Dawned!
A New Day Has Dawned?
Having experienced a most interesting, not to mention humiliating experience in an ophthalmologist office recently; I’d like to announce: Folks, get ready, whether or not Obamacare is in effect now (or even parts of it) or not there’s definitely changes being made by medical practitioners in preparation for it. I’m not talking about the docs that are leaving their practices by the dozens (and who can blame them?) but about those planning to stay in the medical business.
To make a long story even longer, here’s a bit of background. I’ve had a hole in the macula of my left eye for years and in point of fact am considered legally blind in that eye. I consider myself way too old to endure the surgery required to fix the hole (the docs say it’s as big as it can get so don’t worry about the hole getting larger) so I’ve just dealt with it. I see light and shapes with that eye but everything appears to be in the shape of an “X” – in other words the middle of my sight disappears entirely. I had cataract surgery on the right eye in 2005 and it does just fine – which is a good thing as it still permits me to drive, read, etc.
I’ve been aware the bad eye has a cataract on it but it wasn’t until the last year that the cataract became a problem – the problem being my depth perception is now non-existent in the left eye and I’m told that part is due to a cataract. True, cataract surgery will not correct the hole in the macula of the left eye but it will give me a bit more distinct “seeing power.” Also, with age, one becomes more aware of what might be needed in the future and I began to think about injury to the good eye and what would I have left – not much! So, reasoning it was time to get the cataract removed from the bad eye I sallied forth to arrange for cataract surgery on the left eye.
I made an appointment with an opthamologist in East Texas as he had a wonderful reputation (of which I’d been aware for years) and I could stay with my significant other the couple of days required to recover from the surgery and pay a follow-up visit to the doc after the procedure. As I was familiar with cataract surgery, had Medicare and Medicaid, I proceeded to the doc’s office for my appointment believing myself to have all my ducks in a row.
The arguments begin...
I presented all my documentation to the lady at the front desk in the doc’s office and while she was copying everything I noticed a sign on the counter stating ALL patients were required to pay $140 in cash prior to treatment as of 2012. Now, I found this odd as when I’d made my appointment I had verified the doc accepted Medicare/Medicaid. Those two cards indicate no up-front money is required, etc. I questioned the charge for several reasons. First and foremost, I’ve never had to pay any monies up front to any doc that accepts Medicare/Medicaid and secondly – most people on Medicare/Medicaid do not go around with $140 in cash on their person.
My query posed a huge problem for the front desk lady and she promptly pulled out several books and began checking out her information/instructions. She finally ascertained that since I was a QMB Medicaid patient I didn’t have to pay the $140 cash but would have to pay a $20 cash “refraction fee.” I then inquired as to what a “refraction fee” was. A refraction fee is what one has to pay that is going to take the test for a prescription for glasses – you know, which line can you see on this chart and which is clearer to you (frame number one or frame number two?) I assured her glasses were not in my future as the right eye saw just fine and I was only there to arrange for cataract surgery on the left eye.
She rudely informed me whether I needed glasses or not didn’t matter; the refraction fee was mandatory for all patients. It was at that point – and thank heaven I kept my temper under control – I informed her I was not only not going to pay for something I didn’t need but I wasn’t even sure her demands were legal as far as Medicare/Medicaid were concerned and I felt there was a strong possibility this whole check-in process wasn’t on the up-and-up. With that I requested my documentation back and also the copies she’d made of my cards. She gave me the cards but refused to give me the copies she’d made.
Dear hearts, that was the last straw! I assured her, since I would not be receiving services from her doc or her office that she had no need whatsoever for copies of my private documents. She still adamantly and rudely refused to give me the copies at which point I insisted she call her office manager to her desk. When the office manager arrived she explained to me, very coldly, that it was office regulations that all copies of documents made in the office went in their folder whether or not services were administered. I assured that lady I was familiar with office procedures in doctor’s offices after 20 years in the legal field and either she would give me the copies back, shred them in my presence or hear from my lawyer. We all three finally agreed the office manager would shred the copies in my presence and that’s what happened.
So, what’s this story all about, you ask? The answer is simple. Patients on Medicare/Medicaid, to my knowledge, have never been asked to provide money up front. The doctor renders services, presents his bills to the government, Medicare pays their part, Medicaid pays their part and if there’s any balance left the patient is billed directly by the government and required to pay that balance personally to the doctor or whomever it is owed. The head’s up here is all that’s apparently changed. If I’d gone along with the doc’s office requirements I’d have been out $160 right out front, the government would never have known about it and paid the bills presented by the doc -- never knowing the doc got $160 off the top of the whole deal.
The conclusion being: This doc, although claiming to accept Medicare/Medicaid patients, in truth doesn’t want those patients. His front desk lady tells these patients “of course we accept Medicare/Medicaid patients” to get them in the office and then those patients are hit with additional fees from every side – and very few will have enough money on their person to complete registering whether they need surgery, glasses, etc. Some, who can, will go to the bank, get the cash and come back. Most don’t even have that kind of reserves so they’ll just leave and forget it. For the doc it weeds out patients he doesn’t want and assures service for those he can charge whatever he deems right – and with a little research since this incident I’ve found he charges regular pay patients exorbitant fees. Well, who can blame him? With Obamacare on the horizon and part of it already in place prudent doctors better find a way to keep making a living and Medicare/Medicaid patients aren’t high on his list.
I have, since that visit, found that the “refraction fee” is legal and Medicare/Medicaid DOES NOT pay for that part of an eye examination. However, most docs just wrap it up in their other charges and aren’t so bold about it. Fact is, I thought that was just part of what one paid for when seeking services from an eye doctor so how wrong could I be?
Oh, in conclusion, when I got home I had a letter in my mail box from the powers that be at Medicaid (which I've had for 10 years and used twice). They were writing to announce that my Medicaid benefits were cancelled (although nothing has changed in my life -- finances or income) and I'd better find some supplemental insurance to replace it...and there you have it...the age of Obamacare has already dawned (at least for one old lady)!
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