You Can Keep Your (Insurance Policy/Doctor), Can’t You?

ObamaCare_fallingI had it in my mind that I was going to avoid being too political, but I can’t help it now. Here’s a story…

(By the way, I’m not going to use anyone’s name here. If you want to, you could do a couple searches and figure it out yourself, but it’s not my fault :))

Today my wife told me that the doctor’s office she works in ran into their first big issue with Obama care. The doctor is the only certified pediatric rheumatologist in the area. (Yes, the only one).

There are many other similar specialists around, but none of them have been schooled and certified for working for children. This particular doctor has helped hundreds of rheumatology patients – all kids – deal with the pain and suffering associated with their various arthritic conditions. (We happen to know one of the patients who this doctor has helped).

Recently, a major company in the area – who employs thousands – changed their insurance plan from a plan they apparently had for quite some time, to another plan that better complies with ObamaCare (The Horrible Care Act). Unfortunately for this doctor – and the dozens of children he treats – this new health care plan does not include him in their network of “preferred” providers.

In other words, this company’s insurance carrier will no longer pay for this doctor’s services.

So, what does this mean? Well, the new insurance company has substituted another rheumatiologist, who does not have pediatric experience, for the doctor in my wife’s medical office.

So much for the promise of keeping your preferred insurance policy.

So much for the promise of  keeping your doctor.

Obamacare

The biggest problem here is that the parents of these children, who believe in this doctor and his methods, have only two choices – keep their current doctor and pay higher prices, or go with the “network” doctor and risk losing whatever gains have been made for their children under his care.

There is no third (or fourth or fifth) choice here.

Upset parents have been frantically calling the doctor’s office asking for some kind of help. The office has contacted the new insurance company, and practically begged for inclusion in the network, but to no avail. When questioned about the qualifications of the substitute provider and the pediatric certification issues, the insurance carrier has basically said, “Sorry”.

That’s not the answer the parents (or the doctor) want to hear.

And now, I understand a bunch of Democratic Senators are introducing a “You can keep your plan” bill that will basically tell the insurance companies to “not comply” with the ObamaCare regulations. (Like, Congress was ever intended to be dealing with this kind of crap. Riiight).

Too little, too late.

This whole business sucks. Big time.

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16 Responses to “You Can Keep Your (Insurance Policy/Doctor), Can’t You?”

  1. Pria Reply

    CNA Pay In Doctors Office?/ Hours? How much do Cnas get paid in a doctors office? clinique?
    What are their hours also?
    Im talkiing about in a small city. or even a big one?
    By the way, I mean Certified Nurses Assistant.
    I am a cna and i know what cnas do.
    My friend is also one, but she has worked for a doctor.So thats what im asking.
    What they pay is to work in a doctors office, clinic.
    Also what do they get paid in a hospital/nursing homes?
    Just an estimate.

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    • Certified Nursing Assistants (CNA) are not employed in a doctor’s office or a clinic. They are trained to assist long-term patients or residents with activities of daily living such as eating, bathing, toilet, and mobility needs. While they may take vital signs, that is the only thing that they are trained to do that would be useful in a doctor’s office setting. Hence their name “Nursing” assistant. They assist the nurses in the extended care facility setting or some (with some additional training) work in the hospital with their patients that need constant care.

      Now, if you meant a Certified Medical Assistant (CMA), that’s another story; in fact the job/career of a CMA was created specifically to be in a medical practice (office setting or clinic) and to assist the practitioner (doctor, Nurse Practitioner, or PA). They do get vital signs, but also draw blood, give injections, perform EKGs, sterile procedures and assist the doctor as needed.

      Most work regular daytime hours (when the doctor’s office is open), although some that work in urgent care clinics will work evenings and weekends.
      Average pay is anywhere from $10-15 an hour.

      Most Medical Assisting programs are around 9 months to a year in length for the certificate; 2 years for an Associate Degree. A CNA (nursing assistant course) can be anywhere from 4 weeks to a couple of months….depending on how many days a week the course meets.

      Once in a blue moon you might find someone who has taken a CNA course working in a doctor’s office as a Medical Assistant; she won’t be certified as a Medical Assistant and she received on-the-job training from the doctor and his/her staff, but simply being a CNA doesn’t qualify someone to work in a doctor’s office.

      EDIT: Like I said…Medical Assistants make anywhere from $10-15 an hour in the US!

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  2. NewFather Reply

    High Blood Pressure At Doctor’s Office? I am 25 and have not been to a doctor since I was 15. When I was 15, I was fit, athletic and when I went to the doctor my blood pressure was 175/110! He recognized it as severe white coat syndrome. After doing the physical and reassuring me that nothing was wrong, he re-took my bp and it was 110/60ish. Ever since then I have this terrible adrenaline rush every time I even see a blood pressure cuff. The problem is that now I am 25, about 20 pounds overweight and I don’t think I could explain to my doctor why my bp is through the roof… so I just avoid drs visits at all cost, even when I now have other concerns… I monitor it at home with a digital one I purchased and it ranges from 130/70 to 145/90 day to day. I have not had blood drawn since i was 5 years old… any advice?

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    • Seeing a doctor is part of taking care of yourself. You aren’t the first person to have the “severe white coat syndrome”. Physicians are used to it.

      Book your appointment, then take a deep breath. When anxiety occurs, most people either hold their breath or they breath really shallow and that is a sure way to have your blood pressure go thru the roof.

      When you are at the appointment and you see the cuff coming your way, take several deep breaths and try to relax. If the reading is a little high and the doctor asks you about your blood pressure history (which they will), just explain to them that you have had a problem calming down in doctor’s offices before. They will understand and will take steps to help you calm down. Later on they may request the nurse to re-take the pressure. If the pressure is still high, the physician may ask you to keep a diary of your pressure with dates, times and readings just to be sure that you are okay.

      If you continue to have high anxiety for future visits, your doctor can prescribe anxiety medication to be used before your next appointment.

      If you need to take a friend or relative with you, that’s okay too. Having support to get over an anxiety producing event is a healthy way of overcoming the fear.

      Do not let your anxiety keep you from having regular medical care. Part of being an adult is learning to take care of yourself even when you are uncomfortable doing so.

      Good luck. Remember you CAN do this and you are NOT alone.

      Tex

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  3. Pikzzi Reply

    Co-pays At Doctors Office I was just at doctors office for my sons TB shot. i had to pay the copay but i didnt see a doctor. i used to work in a medical office and i remember that when ever a medical assistent seen a patient to give a shot and the doctor did not need to be present the patient didnt have to pay.
    Are all doctors offices different when it comes to copays?

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    • ~~I would check with your insurance company. If the assistant is a P.A. it’s possible to charge for a copay. If not I would definitlty argue the point as it is a copay for a DOCTORS visit. Your insurance will verify whether or not that is against their contract policies. When I worked for a dermotologist we never billed a copay unless the doc saw the patient~~

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  4. Nichole Reply

    I Think My Doctors Office Is A Joke? So my last period was April 23rd, 2007… i went to the doctors in August and they told me by my last period my due date is January 28th…. when they couldnt find a heartbeat they did any ultrasound and said oh its because we were off your really due February 20th… so up until now they had me believing its feb. 20th.. well i had an ultrasound this past thursday to see how big the baby is so far considering im 35 weeks have 5 weeks to go… so they did the ultrasound and it first said im 38 weeks due January 30th and then the machine messed up so they restarted it and it said im 37 weeks and due Feb. 5th and the baby is 6lb 12oz and in head down position… so im so confused and have no clue when im due or what to go by… ive been having braxton hicks contractions and alot of back pain i can barely even walk any more and theyre telling me they wont even induce me until Feb. 13th and theyre telling me hes going to be 11 pounds… and im like freaking out because i dont want to have a
    c-section because i have a 3 year old at home who obviously cant take care of himself… so im like in a rut over here and dont know how to get my doctor to induce me at the end of this month… does anyone know of a good way to self induce labor… ive tried sex ive tried walking… im just out of ideas in so much pain and just really annoyed with my doctors office considering last time they told me my 1st son was going to be 6-7 lbs and he was 9lb 12oz and now they are telling me this one is going to be 10-11 lbs what happens if they messed up again and hes like 15!!! im just really upset i guess and looking for anyway to induce my own labor so they have no choice but to take me

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    • If that office keeps changing your due date because they can’t operate an ultrasound machine, I am sure your insurance company would cover another ultrasound done by another doctor’s office if you call them and explain the situation. Since they are basically giving you a one month range of when you are due, that is pretty dangerous to you and the baby.

      You don’t want to induce labor too early, since you could possibly be due Feb 20th for all anyone knows. Ultrasound weights can be off by a pound, and at your doctor’s office who knows if they are even using the machine to look at the baby!

      Once it gets closer to the end of the month, you could try castor oil. That is the only thing that really seems to work, but it isn’t fun. Good luck to you.

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  5. R. Reply

    Skills Needed To Apply For An Office Position @ A Doctor Office?? I am currently going to college to get a degree in Medical Transcription. I have never worked in a doctors office, but think that would be a good experience for me to have before jumping right in and applying for MT jobs.

    What exactly do I need to know, be skilled at, before applying for a clerical/receptionist position? I have worked retail in the past. I am a good typist, I am familiar with Microsoft Word, and have good computer skills.

    Thanks for any info you can share!

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    • First of all understand that MT and clerical and receptionist are three really, really different jobs.
      Understand the job description when you apply.
      You may be asked to train in medical billing because you know the terminology. (Don’t just assume that SOB is shortness of breath, know your doctors specialty.)
      I know that you probably know this but I am going to tell you anyhow.
      Show up on time. That will help you keep a job faster than any other skill you have.
      Don’t be afraid to ask questions. Depending on the office you will get lots of help or just told to figure it out. You have to be alot more capable if you have to figure it out on your own. Don’t give up, just keep asking questions until you get an answer that leads you to the needed information.
      Be flexible, offer to do be available to do any job necessary.
      Be polite to the patients and the rest of the staff. Learn who is your immediate boss and the chain of command. If you work in a two or three person office you may only be responsible to the doctor. That can be harder to work with.
      In a small office you might be asked to do some Internet work, so be familiar with how to get around medical sites.
      Dress very professionally, nothing cutesy or trendy.
      For your interview wear closed shoes. No toes or heals showing.
      This might not have been what you were looking for, but it is all good advise.
      I worked for four different doctors. Each one had their own quirks but you can work with anything once you get use to it.
      Feel free to e-mail me if you want to talk more about it.

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  6. Janecat Reply

    Colon Cleanse- At Doctor’s Office I’ve tried searching online for a colon cleanse place, but I just find the usual Dr Natura’s and at home stuff. What do you call the one you get done in just a couple of hours at the doctor? Anything willing to share their experience? How does it work?
    Anyone, not anything. :) I’ve tried Natura’s and it worked, but I can’t do that everyday- it’s too harsh.

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    • Doctor’s offices do not do enemas or “colon cleanses” unless there is a medical need for it…..in fact they don’t like doing them then, it isn’t good for you, it throws your electrolytes way out of balance and leaves you exposed to all sorts of opportunistic infections. Yes, laxatives, like natura’s are harsh…actually the word is caustic..and over time you become dependent on them, unable to have a bowel movement without ever increasing amounts of laxatives. your bowel does a fine job of cleaning itself as long as you eat properly and drink enough water, heck it does a pretty good job even if you don’t….don’t use artificial means to “cleanse” your colon, it really doesn’t need it, and it can do you considerable harm.

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  7. Anonymous Reply

    How Do I Calm Down At The Doctors Office? Im a 13 year old boy, and i am really healthy. i hate going to the doctors office no matter how much i know its not that bad. i always go to the doctors office and get extremely nervous and gittery, then i get everything done (shots, blood test, getting balls checked, LOL) and im completly fine and im like, “that wasnt bad at all, next time i will be completely fine.” now its today and i have an annual check up tommorrow and im extremely nervous for it. i hate the anticipation and it really sucks for me. please tell me how i can calm down i bit and not worry about it.

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    • Those irrational anxiety/fears are a pain aren’t they?

      The deep breaths actually has more value than alot/most people give it credit for. By controlling your breathing you are doing at least two things.. 1) occupying your mind (focus) and 2) controlling your sympathetic nervous system. It does calm you down, if you give it a chance. So it is a good way to figure (after some practice) that YOU do have control over this body of yours..

      What really is at the core of this is that it feels like you can’t control it, you don’t know what it is, what causes it.. or why! Frustrating, the unknown especially when it effects your ‘well-being’.

      Further you need to ask yourself.. “Why am I feeling this way?” — Really.. ask yourself and think about it.. write it down.. it helps get the thoughts out. Ask yourself “What , based on experience, will happen and what could possibly occur that would be scary or create anxiety?”. Just ask the questions you may be afraid of.. don’t worry about it.. you may think how is that going to help?

      Well establishing the link that your feelings are based in irrationality (fiction) (things that aren’t true) and realizing it with the very thing that is creating those thoughts helps to reduce or even eliminate them. Use your mind to control your mind.

      Use your body to control your body.. (ie: breathing.. even exercise, etc).

      Lastly, if nothing works too well before the visit,..when you see the doctor, go ahead and break the ice and say Doc I get really nervous for doctor checkups and don’t know why.. or however you want to say it. He’s heard an seen alot worse than you and he should ease your mind.

      I have the same personality where the anticipation of something the next day or coming up is a LOT worse than the actual event 99 times out of 100. Eventually if you do it enough you do just get used to it and it won’t bother you, but if it is a once a year checkup you generally don’t get enough “exposure” so to speak to make it routine.

      You’ll be fine, you know it.. just know you aren’t alone, it is very common. Technically with doctors it is called ‘white coat syndrome’ — yes there is a name for it. And we all know it is just plain anxiety otherwise.

      Take care,

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  8. Vimmy Reply

    Doctor’s Office Staff Is Arrogant Should I Fire The Doctor? My doctor promised to set up gall bladder surgery for me right away. But after I left a voice mail question about whether a test was necessary his patient coordinator has done nothing about the surgery keeps rudely putting me off and says she can’t reach the doctor. Now he’s going out of the country. Am I being dumped for asking a question? Should I find another surgeon?

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    • Cal the doctor’s office. Say “I need to send a fax, could I have the fax number please?”

      Then, you write a letter to the doctor detailing the questions you have. Be nice. You catch more flies with honey. State simply “I have tried to reach you. I was told you were out of the country. I hope you had a wonderful time and will contact me soon” Sign it and put your phone number under your signature.

      Fax it. If it is in writing, the doctor pays attention. If that chick was not telling the truth, he will know what she said because you wish him a nice trip.

      He will call you, trust me.

      Been there.

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