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From: halle1@houxz.UUCP (J.HALLE)
Newsgroups: net.med
Subject: Re: insurance and doctors fees
Message-ID: <869@houxz.UUCP>
Date: Mon, 25-Jun-84 14:58:21 EDT
Article-I.D.: houxz.869
Posted: Mon Jun 25 14:58:21 1984
Date-Received: Thu, 28-Jun-84 01:43:54 EDT
References: <2121@mcnc.UUCP>
Organization: AT&T Bell Labs, Holmdel NJ
Lines: 16

I think you miss the point.  Doctors cannot charge different fees for
different people based on their insurance coverage.  Their fees must be
uniform.  It is possible they might not collect the same amount from all
patients, but that is a different situation.  The coinsurance that you
mentioned is not unique to Medica{re|id}, but is a feature of most Major
Medical plans.

Also, I do not follow your reasoning with respect to the companies reducing
their payments.  If a doctor charges $100 for a procedure but only collects
$80 from the company, how could a company say his fee is only $80?  The only
way I see is if the doctor failed to collect the $20 from those who were
obligated to pay, such as Medicare patients.  If the doctor did indeed always
write this off, and especially if he only charged uninsured patients $80,
then his fee really is $80.  In this case the company is correct to reduce
his payments, and should prosecute for insurance fraud.  But if he tries to
collect $100 from everyone, then that is his fee.