Working in billing of medical field here. Caregivers are being instructed to get more revenue from patients by asking if they are in pain or other concern from the well visit. When the naive patient responds naturally yes, the visit automatically becomes a diagnostic consultation that the patient will have to pay. It's ironic but when you go to your anual visit, just say you are great and your doc will code it as well visit.
OMG! Stop calling it your annual exam or well visit. It is a PREVENTIVE CARE visit. Preventive means that you are going in to talk about preventing new issues and not treating any form of disease, sickness, or pain. Disease, sickness, or pain falls under diagnostic. Doctors make more money by telling you to not talk about any sickness or pain and coming back for a second visit than they do by asking if you have any pain. Because insurance companies will pay them for the preventive and then again 3 days later when you come back in to talk about whatever ails you. Nurses and doctors are trained to just ask you certain questions and most don't even understand billing or insurance claims. Hell, I used to have to explain to doctors how their own insurance works by breaking it down as simple as I would for you and the same as for nurses. If your doctor's office is having nurses purposefully convert preventive care to diagnostic then they are idiots, because that could be 2 appointment visits instead of one.
We don’t do well visits, but in the old days (>40 years ago) the PURPOSE of a well visit is the UNCOVER problems. PROBLEM ORIENTED visits have NO TIME to address those creaky shoulders. We spent a lot of time for them, and we developed a comprehensive plan for the future, addressing EVERYTHING we could/should address. But guess what? Speaking and thinking take time. And time is money. And thinking is valuable, as I assume medical personnel are worthy of their wage, as it were. And I believe Clark is WELL COMPENSATED for his thinking and judgement. Is Clark willing to give anyone a low budget financial plan? But not your physician. Ok, lie to him/her, don’t mention the chest pain, the weight loss, the blood in stool, abdominal pain, etc. Save a few bucks. I hope it’s worth what the doc might miss. The problem is the insurers and to some extent patients devaluing medical service. Insurers do not want to pay for anything and force this false dichotomy on us. This makes us physicians bill more when we assess/discuss/treat more. But the patient expectation is cheap! OK, get Amazon healthcare! Doesn’t that sentence worry you? Sure efficiencies would help. But the hardware and software is very expensive. And you would not believe how many people cannot manage a tablet interface. But to the point, go cheap! Just an oil change. Anyone can do it. Remember, in most venues low bid does not get you quality.
Listening to the medical insurance questions and replies has reinforced my decision as a US citizen to get a medic alert bracelet that says, "If found down, confused or nonresponsive, don't help me. Leave me by the side of the road to die. I can't afford to get well."
re: airline tix...price it both ways....in my market to NYC , one way $164 and RT=$189. So, RT works for me in my market. Takes just a minute to check both ways, one way may work for certain markets. I use google flights price tracking which alerts me to changes automatically thru email ,it's a terrific assistant and saves me on fare expenses
Is the google ‘flights price tracking’ what you use for specific flights. I heard about a google search which shows cheapest fares to different destinations. I can’t remember the wording used to find those fares.
What I think is going on is they have changed the term from 'Annual Physical' to 'Annual Wellness Visit'. I, too, have found myself saving up some issues to cover during my Physical, only to find my doctor getting annoyed with the 2nd or 3rd thing and saying, 'you really should be scheduling a separate appointment for this.' I blame the insurance companies.
As a healthcare provider, I have worked in the health insurance industry and at a hospital. You have to think of visiting your doctor like going to a restaurant. If you only order what’s on the menu, you won’t get charged extra. Any modifications then you will get charged extra. Also, healthcare providers and hospitals want to turn over patients just like a restaurant wants to turn over tables. they will get paid more with more patients/customers they see. It’s terrible but healthcare is a business, and anyone thinks differently has not been in the industry long enough. If your local hospital seems like it’s always under construction, ask where the money comes from.
Yep! Everyone wants to complain but nobody wants to change it. They always talk about us RNs “working at the top of our license” but don’t give us the independence to do so. We are stuck doing the MAs and CNAs job. 🫤
Your analogy would be better if you include that when going to the restaurant you get served water or bread, things you assume are complimentary, only to see the bill and noticed you are being cahrged. Thats called a surprised bill and more and more medical facilties are resorting to this to fatten up their bottom line. Its a busineess like you said and nowdays money is more important than medical care. Can't wait for AI to disrupt the entire medical industry.
In a restaurant you get the prices on the menu . In healthcare you do not. I have this issue now with Kaiser. Also, Kaiser is billing me 5 times the amount that I could get in other facility. Do not plan to pay Kaiser
I travel a lot for work and have been for years. I have NEVER seen it where a 1-way ticket price is cheaper than RT. 1-way is almost always double the price of a RT ticket. This is true whether it is a domestic or international flight.
Not true at all. For all my travel i have never bought a rt. Two one-way gives you way more flexibility and the best deal, unless you are booking a one-way during an event in the city you are leaving or visiting.
I agree with deejay, every single time I have tried to book 2 one way , it is always way more than the roung trip . Airlines are such a rip off these days I don't even want to fly
23:59 billing is completely unethical now. For my annual, or almost any other visit, anything over 15 minutes, they charge for 2 visits. So I’d still have my co-pay (under old plan). I’m in Dayton, OH and that’s how the two big companies do it (they’ve bought many providers - almost all family care). My NP tells me that she shouldn’t give away her time - I agree, but also she’s not getting that $$. (She is 1000% worth every dime). What’s crazy is I go to my endocrinologist, in a Cincinnati hospital practice and am billed LESS. I get on a soapbox about this stuff; it’s truly criminal in between the insurance companies, big Pharma, and now our local health conglomerates.
I fly a lot now and I have been buying one way tickets for the last several years. The reason is because it IS cheaper. BUT you need to be able to be flexible, so I look at what dates have the cheapest flights and I'll try to fly on those days either coming or going. Also, I have also stopped using any other method to book tickets such as Expedia or whatever for the specific reason that if you have a problem with your flight, the airlines can't help you. And you have to go through that third party and it doesn't always work out very well. My sister-in-law went to Europe like that and something went wrong and she was stuck in whatever city was her layover and ended up spending 24 hours stuck there/ having to get a hotel and missed out on a full day where she was going because she had a third party ticket. There's my 2¢!
I still use Expedia and it’s okay if nothing goes wrong. When things have gone wrong, things have usually worked out pretty well. I always fly really cheap. I’ve found one ways to be more expensive at times, as well as booking on the site. I always fly different airlines on each leg though, whichever works best for me on that flight. I’ve done that for decades. Thank you for your 2 🪙
@@spinnettdesigns Good input. I actually just spent a couple hours today with my friend who wanted to fly from Minneapolis (where we live) to Florida end of Dec to early Jan. Of course over the holidays prices are way more expensive and her round trip flight was going to be $800 plus. I suggested that we look at 2 one-way flights and was looking them up and checking different airports to see what would be cheaper because I have a place in Fort Myers and I could pick her up at Tampa or Miami or Orlando and drive her to her friends (where I would stay overnight too because I know her friend). I found her a $219 flight TO Orlando and a $194 flight back FROM Orlando. (Orlando was definitely the least expensive airport out of about 5 major airports that i checked) So with her checked baggage and paying for some seats, her price out-the-door was $500 so she literally saved $300. I know sometimes it is better to do the round trip but I always check it and it usually works out to be better one way but that's also probably because I have the flexibility and I choose my dates according to what's the cheapest. There's my 2¢!!! 😁
@ thats 4 cents now 😂 I’ve traveled a lot and k know what you mean… It’s easier for me bc I never check baggage and I’m my own boss, so I’m flexible, and that makes it WAY easier. I helped a friend save a similar amount in October, going from San Diego to New England. Rental car too…but we did it on Expedia! Thank you for your thoughts, they are appreciated.
Even Kaiser physicians don’t look at your medical records before your visit . Nurses still ask the same questions like what meds you take . They simply don’t have time when the brass wants 20 patients or more a day to be seen.
I am with Kaiser and agree with most complaints about them. That said the medication questions are needed as we often change what is prescribed and what we actually take. This gives them a chance to get the record in sync. Especially when it comes to prescriptions that have refills we no longer use.
@@markliechty6434 Yeah, the updating of medications is important each time. It's the nurse asking you the same questions the doctor will ask you (not medications) so that you have to tell your story again, but you leave out some things because you think you just said that (which you did) so the doctor does no get the full picture. Also, there have been many times the nurse conveyed inaccurate information to the doctor that I have had to undo. They want to put me in a category that is typical to tell the doctor why I am there. I'm told that the nurse asks those questions so as to be sure the doctor get the full picture, but it ends up confusing the issue instead in my experience. That's why I prepare a short narrative in print for them to say all I want to say so no one can cut me off and so both them and I can have a full record of each visit.
The medications question is necessary since there may be changes, especially when patients see multiple specialists who prescribe. I have seen cases where the question is not asked, with the result that patients are taking incompatible or overlapping drugs, or drugs to treat the side effects of other drugs when it would be simpler to change the original to something that does not produce them.
Regarding unexpected charges at an annual-physical visit: the medical practice I go to now goes over that with me at check-in (sbd earlier). The intake form has two sections. Part 1 explains what's covered in the exam. Part 2 asks if I'll also want to bring up new concerns, reveals that those will be separately billed, and wants my go/no-go decision and a signature. Evidently, though, any updates or questions about conditions already under the doctor's care are not subject to additional cost. This can be individual and will depend on the terms of each person's contracted medical insurance plan. - At least, though, the practice I use reveals everything up front.
18:33 i’m with you, Clarke! I still can’t believe they’re pushing paper. I’m almost 50 and went to the OB/GYN and they gave me a clipboard to update my information and I had to fill it out and it was on paper. How stupid and a waste of resources!
My doc told me that anything not related to the normal annual exam would / could require a separate appointment. I took that as extra on the annual exam bill too. And that they are under a time frame per patient, I believe it was 15 minutes. It was never like this before.
That is absolute bullshit, this is the way it has been billed for many years. If you bring up a sickness, you are billed for a sick office visit as the diagnosis code differs from the preventive care billing. There is absolutely nothing that has changed in recent years. I have been out on disability for 4.5 years and going back almost ten years before that, when we processed claims we processed by the diagnosis codes. The diagnosis code explains why you are there. If you think you can go in under a preventive care appointment and get treatment, and have the insurance company pay for it as preventive you are asking the doctor to commit insurance fraud. If you are getting treatment, you are sick; if you are sick, then you are not there for preventive care. If you want one free appointment a year, then book 2 separate appointments on two different days, and don't talk about aches pains, or sicknesses during your "Free Appointment". When I worked for the insurance company it was policy to inform members to not talk about anything during the preventative because it would change it to a diagnostic. My doctor 20 years ago used to tell me about this too, and I would laugh at them because I processed claims for the insurance company. I would tell them, that it will cost me more $$$ to take off time from work to do two appointments than it will if we just book an appointment for both things on the same day. This is nothing new and there is NO SCAM going on, if you are sick that doesn't qualify as a preventive care visit. A preventive care visit is just that a preventive care visit.
@@RiverWoods111 So what exactly can we do at the preventive visit? Can we request blood work to be done? Can we go to walk-in clinic and request it to be a preventive care visit? A few times I called my Doctors to schedule one, they'd always tell me that the first available for it is weeks or months later.
I had a problem with a leg muscle and went to an orthopedist. I mentioned a sore knee the I thought could be related and the clerk (not a medical professional) snapped at me “well you need a separate appointment for that.” I had Covid and because of my age didn’t want to fool around. I went to what I thought was an urgent care place where I wasn’t tested but was told to go buy a test and if it was positive call them and they’ll call in a prescription. The PA didn’t even examine me. I got a bill for a new patient visit. They called the prescription in to the wrong pharmacy a day later and it was going to cost over $400. I left it there. People wonder why I avoid interacting with the medical establishment. I can only imagine how frustrating it is for doctors to find themselves subordinate to the bean counters.
There are several so called concierge doctors in my area. Cut out insurance and get unlimited access to your doctor. The kevel of access and care is amazing for a small monthly membership fee
The monthly fee is NOT small, and any lab work, tests, hospital charges will fully be on the patient. It isn’t a feasible replacement for insurance unfortunately
@@RootBound505 completely right, not a replacement for insurance to cover bigger things. Fees in my area for these types of practices seem to be $75-200ish monthly, dependent on age and practice.
Facts. The fact that people buy a new car every 2-3 years is insane. What is even more insane is leading unless your company gives you a car credit as compensation. Them if you aren’t paying for it who cares
This happens 100% of the time in my area- thay then bill the insurance company for the physical and an office visit for the additional complaints you had (such as the shoulder popping ) then you have to pay your co-pay. . This has happened to me for the past 15years. That is why when you sign the consent to treat- it says you are responsible for any charges not covered
I have insurance through my employer, and we are told during orientation each year when we renew the plan that for your annual physical, you cannot ask any other questions or you will be charged. The other thing I seen was about changing of the coding we will also told by our employer if you go in for your preventative colonoscopy if anything up or anything shows up then it changes from just your preventative one to one you have to pay more for.
At my urging, my 30 year old son went to a PCP to establish care and have an annual checkup. His insurance covers preventative services. The Dr. examined him and ordered bloodwork, all standard stuff. He was charged over $300 for the Dr. visit and the lab work. When he called the insurance company, they said he had to ask the Dr. to change the way it was coded. When he called the Dr., he was told that they couldn't change it because this was a first time visit, which makes absolutely no sense. If the Dr. won't change it, what else can he do? He paid the bill, but says he is never going back to that Dr.
Sadly that happens alot. Your son should fight it. The medical scare is fukn scam nowadays. My friend had similar issue.he called every where and got it removed. And posted online. And filled complaints.
Same happened to me, and I used to work in health insurance. Only the doc can change it. They double bill even with all the regulations and get away with it.
It’s not the doc. The government set it up this way. My husband is a retired physician, and said that if you go in for your annual physical and mention a problem that you want the doc to check out, the preventative visit becomes an office visit, and you are then charged for it. That’s a simple example, but there are other factors. It’s probably best in this day and time to clear this up before you are seen by your physician.
@@JJ-ur9yp So the office I have been using for thirty years tried that on me. So the next time I went in. I stopped my doctor and told him that this was my free checkup and to not speak to me about anything that was not covered
We Canadians have been using video healthcare since the Pandemic started. It is a great way to cut down on the backlog in the healthcare system and I am a huge fan. Of course there are always times when you need an actual in person examination but I think it’s a great way for them to see more people efficiently. Great video by the way. Thanks!
I have never had this. I go to a doctor who is HCA provider, every physical she ask how I am doing. We talk about all kinds of things going on, I have never been charged an extra fee.
Our health systems in the USA are broken. And they are broken because of the ill-conceived notion of medical insurance. Insurance companies are in business to make money. And, these days, it's very competitive. The insurance companies cannot afford to cover people without these sinister practices.(and still make a profit) I think insurance companies should make a pact to cover an individual for life, not just year to year. Then they'd be sure to assist parents in ensuring kids get proper nutrition and exercise.
24:00 EVERY TIME I go for a physical, they find some way to bill for things that are not covered under the free physical scope. How have you not encountered this?
That was happening to my husband. I called and found out they were billing him each year for a recheck of blood work, and not scheduling and billing his free physical. Now when we make the appt we make sure that it is scheduled as a physical.
There is no point to go to a doctor for a "well care" annual visit that just gives them an opportunity to prescribe drugs. I have a blood pressure monitor, glucose monitor, scale etc etc plus I order my own blood work and monitor my own health.
The fastest way to get sick, is start going to the Dr's office lol. Seriously, they will find something that isn't perfect, according to them, pre diabetes, slightly high BP, Cholesterol, something. Then once you start the pills, forget it. Unless you have a reason to go, don't. Breast exams etc are good, but the regular physicals, bad news.
At both my care providers in the US, the office had disclaimers on all the forms, website, and in the office warning that if the patient asks any questions about perceived ailments, the charges will be billed as diagnostic.
I've done this for two years. It wasn't for financial reasons, but for scheduling freedom. But I have come out either cheaper than roundtrip, or at least in the same ballpark.
Regarding the bone density test, you should appeal the decision! First, discuss vigorously with the office, as administrative errors happen, that it’s a diagnostic test, obviously. Second, appeal to the insurance that its diagnostic, no previous condition exists, and urge the importance of the insurance company saving money by paying for the preventative care rather than paying for the disease care. Insurance companies also make erroneous clerical decisions.
They do charge for questions during the dr vist if it is annual vist I always said America practice is Rockefeller medicine this is one example of many
My doctors office is doing the same thing. A family member went for a sports physical that we paid cash for and got a receipt. My wife asked a question and are now being billed $317.. About a month after the visit we received a bill for the $25 we had already paid. Called and they said it was a mistake we didn’t owe anything. Then about 3 1/2 months later we received another bill for the $317. The charges are: $25 we already paid for the sports physical $12.97 pure tone screening ( what ever that is) $25.94 visual screen Quantitative B $253.14 OV Est Pt level III (what ever that is) Talking to these people is like talking to the wall. The last conversation they said they would bill our insurance for the charges.
Pure tone is a hearing test. Some insurances do not cover a hearing or vision test as a preventative service and some insurances do. Level III is the minimum level of service a physician performs. That means your condition that was treated that day was a minimally complex problem with few or no tests, labs, studies, or reports to review. Also the treatment was minor such as prescribing an over the counter medication, treatment, or additional new tests. Or the total time it took to cover your assessment and documentation was a minimum of 20 minutes. So…level III is how a physician documents and bills their time, much how a lawyer bills for their time. You probably only paid $25 for the paperwork entailed in the sports physical and now the other part of the physician assessment. Btw there are no diagnostic codes for sports physicals. So if an physician tries to get reimbursed for their work from the insurance company and says the patient was seen for sports physicals, the claim will be denied because it is not attached to a valid diagnostic code and the physician would have done all that work for free and never have been paid. That being said, if you paid cash for the whole visit up front, they should have been more transparenta about which additional services you were paying for. We tell people when they request additional hearing, vision tests, etc that the insurance may not cover those services during an annual physical
Every single time I ask for a receipt for the co-pay of $25, later I get a bill for $25. Then I called the office and they tell me to ignore the bill. Note that the receipt never has the date or what the receipt was for. So now my husband and I write the date and what was done at that visit because it’s so easy to forget. But this has happened at least five times in the last six months.
I haven't traveled abroad in a few years but I found many places did not want to accept a credit card (this was Croatia). Any small, under 10 Euro purchases and they were quite displeased.
That should tell us something about how the global financial corporations are ripping off small businesses everywhere. That’s why they strongly prefer cash.
Big difference between business credit and corporate credit. Business uses your social corporate uses your run number. Be sure to build corporate and don’t confuse the two
What a coincidence! I actually bought a 2013 Hyundai Accent used several years ago partly because that model had a great maintenance track record. I've been very happy with it... It's up over 100,000 miles now...
I just did this less than 7 days ago. It BACKFIRED on me. I ended up paying MORE than if I had just booked the roundtrip. I used Southwest, booked the tickets on different browsers, and I was *not* signed in. The 2nd browser is an anonymous browser.
During a physical when the dr asks how i am feeling, i just say fine and have learned to NEVER bring up any medical issue he does not bring up first. They have and continue to charge extra for that. Same with diagnostics. Colonoscopy is deemed preventative and covered 100%, UNLESS they find something. Then it is switched to diagnostic and NOT covered by insurance. I've had several different companies that bill this way. It's a racket.
All things being equal buying a car under business enables you to walk away from a car loan without damaging your own personal credit, which is more critical for mortgage etc. In this case your cat loan is under your llc you don't even need to declare your car loan in a mortgage application.
Sadly that is how it works woth annual physical. There is a checklist of items that nurse and doctor go through for a wellness check or annual checkup. Ive had that happen and doctor says Ill need to make another appointment tondiscuss thst matter sonce this is a annual physical exam.
They accept all of the major insurance providers for membership services. If you elect to do pay-per-visit, it's self-pay only but is FSA/HSA eligible. 💚
the Annual Physical ideally should be dedicated to updating mammograms, colonoscopies, vaccines, screening for vision or hearing loss. Also discussing healthy diet, benefits of exercise, use of sunscreen, sexual health and STD prevention, importance of good quality sleep, stress management, etc. Doctors are often criticized for not focusing on wellness and instead benefitting from disease/illness and pushing prescriptions. This is our once yearly opportunity to plan how to keep patients as healthy as possible.
THE RADIATION FROM ANNUAL MAMMOGRAMS RAISE THE CHANCE OF GETTING CANCER. DOC TOLD MY MOM DECADES AGO. JUST A HUGE CASH COW LIKE EVERYTHING ELSE! A PATIENT CURED IS A PATIENT LOST. THINK!
Thank you for all the great information. I recently consulted with an attorney regarding a will and estate planning. Their fees seemed especially high for my needs. But, in part of the consult, one of the items that was included was a health care POA that was stored online. We would receive a card with access data so medical professionals could see it online. This seems like a great idea. But, I can't locate anything like that online. Are you aware of anything like this?
Clark & Team - You are misinformed regarding additional questions at “Annual Physicals. Unfortunately, if a patient asks questions OUTSIDE the scope of what is generally covered, you can be billed at the “re-established” visit code. Translation - additional costs. Same situation happened to me! Even involving my insurance, the office refused to revise the billing code.
In many instances, when traveling internationally, you don't have the option of NOT BUYING a round trip ticket! Governments in the places you travel to INSIST that you have a round trip ticket, or they won't let you into the country!
You blew the preventive physical exam question. This is a Well Visit and per coding guidelines if additional problems are addressed that are "significant, separately identifiable, medically necessary, and reasonable to treat illness, injury, or improve functioning of malformed body part" can be billed in addition to the well visit. The staff should have asked when rooming the patient if he had any new concerns and inforn there would be an office visit charge. The patient can then decide if he wants to discuss these concerns and pay for this extra service or come in another day to discuss these problems. The provider was saving the patient having to make another appointment having to take more time out of his schedule, but the patient should have been informed.
While as a healthcare consumer (only) who has run into this situation, IMO "blew [it]" is a bit harsh given they were speaking generally about public perception. Anec-data: A bit over a year ago I was approaching one of those decade ages and ahead of my annual physical I increased (from a low baseline) my exercise. To show it's appreciation, one of my knees self-destructed about 2 weeks before my scheduled appointment. Fortunately I had observed the signs in the exam room during previous year's physicals that indicated any health issues raised during an annual physical would be treated as a separate visit, so I called my provider and changed the nature of my existing appointment and had them book my physical for another few weeks later. Ironically (or paradoxically?), during the annual exam she asked about my knee, possibly as it was an established part of my medical history/known condition (or whatever). So, yeah, the American healthcare system is great, as long as your goal is to overpay for worse outcomes and feel terrible while doing it!
🦨 #clarkstinks Thanks for your feedback! No one on Team Clark is a medical professional, so we're answering questions based on what seems fair from the average patients' perspective. Historically, asking questions while you were already in the doctor's office did not incur additional coding and charges. If that is standard verbiage at most doctor's offices now, this needs to be communicated to the patients - outside of the 12-page terms and conditions that most people don't read. When someone asks to take a look at a shoulder pain in a routine visit, the doctor or nurse should say, "We'd be happy to take a look at that! Just so you know, it will be an additional charge." This way, patients can decide if they want the doctor to take a look at it or not. 💚
@@Clark in Massachusetts this changed for me about 5 years ago. Any discussion you bring up turns is considered a separate office visit. And charged as such.
Recently my doctor's office put up signs saying that any medical questions outside of the scope of the initial visit COULD BE charged separately. That was not the case with annual check-ups in the past. If the point is patient care and prevention, answering a few 30 second casual questions, during an annual update, could save trouble down the road and lead to far better patient outcomes. Treating every question as a billable event is silly, for most health maintenance questions. I wouldn't expect free treatment for a broken ankle at an annual physical, but if I've been a tad sluggish as I age, I wouldn't expect a bill for the doctor to suggest a morning exercise or two. So far, my doctor's office hasn't billed for anything but the physical. But I also now ask, hypothetically, the billing question - if I will get a charge for the category of question, before I actually ask it. If they ever said yes, I wouldn't ask, and I would check out Dr. Google instead. That's where mad billing will lead. And most folks won't be looking for peer-reviewed journal articles from respectable publications, they'll just try crazy internet suggestions.
That is the dumbest thing I ever heard. A normal preventative checkup is to go over any concerns. That is the point. You are supposed to bring up any pains or issues as part of preventative care investigation otherwise it is not a normal preventative checkup.
I guess I'm driving for free also. I have a 2006 Toyota Highlander what's 226,000 Miles. I get all the oil changes on time at the dealership which I buy a package deal at and the oil changes cost about $20 more than at a Jiffy ... Plus I get 100 point inspection list which tells me which things need attention especially scheduled maintenance. I think this is why it's lasted so long because the previous owner did the same.😊
Oh no same happens at my doctor office. They no longer do an annual check up. They literally do a well baby on an adult eyes, ears, nose and throat and you’re out of there!🤯
Love this guy and his lady friend. Great information on buying airline tickets. I like to go right to the airline website and look at the calendar for the daily prices. It's funny for a Tuesday maybe 79 dollars and the next day will be 159 dollars
so if i buy 2 one-way tickets on separate airlines and there’s a “major schedule change” on one which breaks my trip then im out the money for the other ticket 😮
I wonder if 1-way will find you a later flight for free if space is available if you "miss" (for whatever reason, you don't have to say) your flight like they do with rt tickets? Would make sense if they did. You really already paid for your ticket...you just missed that particular flight.
I received a text from my OB/GYN stating the list of questions. I am allowed to ask while I am there, and a list of questions that are not covered by medical Medicare. What shocks me is that the whole idea of going to that type of doctor is to care for the list of questions that are not covered by Medicare. It is shocking, it is absolutely shocking, shocking, shocking, so please know that there are many of us that are experiencing this. Please please Clark address this matter please please we need your help
No, you don't need insurance. You can opt for self-pay. In fact, if you're using pay-per-visit, they don't accept insurance for this service (membership visits can be billed to insurance). Pay-per-visit is FSA/HSA eligible. 💚
Just did annual wellness DR appt - 3rd yr this DR. What was new -- 2pg form to sign before the appt - spelling out what was wellness visit. My guess, the goal to stop wasting everyone's time when the billing hits & the angry calls begin for an explanation and to dispute the charges. For me previous 2 years had to call DR office for recoding so that insurance would reverse the charge. For me it was 100% wellness. As I say to them: just here for the gatekeeper to provide order fo annual screening blood lab. My gripe -- why insurance requires DR order vs just go directly to the lab. If lab result shows something out of range, then makes sense to have a DR appt.
One of our Clarkies told us about a company called Own Your Labs. It's a website where consumers can order labs directly, without a doctor's order. Team Clark has not checked it out yet, but it may be something you'd want to look into. 💚 ownyourlabs.com/
I feel like I could have flown halfway across the country in the time it took him to finally get to the simple point (two one way tickets might be cheaper than one round trip).
I got bit by the diagnostic vs screening scam. I had the insurance rep and the provider rep on a 3 way and the provider insisted that they could not legally change it to screening. I think it was total BS, but who knows. Anyway I had to end up paying myself.
If during an annual physical/preventative exam, if a separate problem was discussed ( like a bad headache. finger pain/ shortness of breath, Blood pressure issues'- the provider will have to bill for 'preventative 'visit and also for the 'acute visit/diagnostic issues'. They will not be able to change the code.
Clark, you left out another MAJOR reason for not buying round-trip tickets. Airlines apply a methodology called "married segment logic". How this affects you is that if you buy a round trip ticket let's say from point A to point B and from point B back to point A. Now, one of the legs is now cheaper so you call the airline and say that you want the difference back. They say "wait just a minute cowboy, not so fast.". Before we can refund the difference we have to REPRICE the entire trip first. This will likely reprice your round trip ticket higher negating any savings from the one leg that is now lower in price. When you price a round trip itinerary, the airline is pricing two one-way fares to begin with. "w
Air ambulance is typically covered, although ground ambulance is generally not covered. A small number of states have enacted laws to protect against surprise bills for ground ambulance services. 💚
They do Healthcare better almost everywhere else in the world. But here in the USA, we are married to capitalism, so money takes precedence over people. We aren't smart enough to research Healthcare in other countries and model that because we couldn't dare admit someone else does something better than the USA. My sister in Australia got a knee replacement for $200. Dr visits are a small copay and all meds are paid for. Her husband has dementia and he's in a nursing home. It's all paid for. They take care of their people in Australia. Her taxes are not terribly high, and she does not wait a long time to see Dr's, nor is she receiving sub standard care. We are being lied to so a few people in the United States can be mega rich while the rest of us struggle.
You go to a preventative medical visit and the doctor says "I see your number for [chronic condition such as hypertension or diabetes] has changed and so we'll adjust your medication, an additional "code" is added and there is an additional charge because this is now diagnostic. Legitimate or not?
If your doctor wants to change the medication- You will need to let doctor know- not to address those and that you will come back another day, to discuss those important issues. Then there will not be additional code/charges
I have to disagree with Clark on squeezing all the inefficiencies out of medical practices. It has gotten to where doctors and other medical workers are more concerned about following corporate policies, checking boxes, being cognisant of legal ramifications, and using AI to diagnose rather than listen to the patient fully as an individual, a person not fitting into the typical conclusions. I can tell that my doctors are frustrated with their EPIC programs they are forced to use. Then, of course, there are the insurance companies also telling the doctor how to do their work and what they should do. No wonder so many doctors are leaving the field and many bright young people are steering clear of the field. We all suffer because of it. And then there are all those who can't even afford health care at all. Our system is a mess and technology and efficiencies are not the answer!
Comment based solely on the title of the video: Booking a one-way ticket is a surefire way to get the dreaded SSSS on your boarding pass. Why would you sign up for extra, invasive security checks?
Whaaat they don't just pierce a corporate veil... There has to be a court ordered reason. There is absolutely a better advantage for buying the car through business if she is 100% using it for business.
Clark, there are older adults that are not tech savvy. Great for you that you are tech savvy, but please consider others who are not when making blanket statements about the practice of still using paper.
tell lady w old car:j change cabin filter (do it yourself...look in manual. buy at parts store.$30. Engine air filter, too. easy !!! Put in new battery. Parts store can READ battery. tell you three readings, how its doing. Batteries have gone up in price. It just is.
As a physician I will let you know that a physical exam is for preventative screening. Any specific concerns that are not preventative screening are considered a “problem visit.” Aka “hey doc, I have this problem I would like you to fix.” If you are getting a physical you don’t pay for the preventative part of the evaluation that day. You do pay for the chronic/acute problem you want us to assess. We commonly tell people that if you have a problem you want addressed you will pay for it. I’ve worked in places where it is on a sign at the desk or a document you sign acknowledging this. That applies to all insurance across the board. If you have insurance that doesn’t require you to pay for problem visits (ie., Medicaid) you probably never noticed the doctors office was billing the insurance company the whole time for that. For the woman with the bone density scan bill. She should address that with the radiologist or owner of the bone density scan 95% of the time her primary care doctor does not own the machine and does NONE of the billing for tests. All handled by a third party. Contact the radiologist or hospital first. Then call your doctor.
Can you help me with this question please: If I don't take any routine meds, I'm not sure what the point is of having an annual physical. I can check my weight, temp, B/P at home by myself, and that's about all that is done these days for an annual physical, if I can't ask what a new minor acute problem is, I'm not sure what the point of the annual is other than to have my doctor review blood results, and I don't need an office visit for this process.
@ I will not give specific medical advise. But, I will answer your question generically. Depending on your age you may be due for certain cancer screening (ie colon, prostate). You may be due for certain vaccines based on age. Or other lab testing to ensure you are still healthy ( cholesterol, diabetes, etc). I still recommend patients come for a physical once per year. Every day I have the unfortunate task of diagnosing someone with a surprise new condition like high cholesterol or diabetes. That evaluation should be free with insurance. You can still see your doctor for acute concerns. It’s just not typically covered 100% by insurance.
Exactly why I left the insurance backed primary Dr practices. My first visit with a direct billing practice was 90 minutes face time with the doctor. Actually get the care and consultation I need to proactively take charge of my health.
Working in billing of medical field here. Caregivers are being instructed to get more revenue from patients by asking if they are in pain or other concern from the well visit. When the naive patient responds naturally yes, the visit automatically becomes a diagnostic consultation that the patient will have to pay. It's ironic but when you go to your anual visit, just say you are great and your doc will code it as well visit.
But is it really wise to NOT discuss things you are concerned may become a bigger issue or be treatable?
@@ttb1513 The catch 22. To not be ripped off, or to be healthier. So awesome that we have to choose.
I guess we all need medical coding books! They do sell them online. Just a thought.
OMG! Stop calling it your annual exam or well visit. It is a PREVENTIVE CARE visit. Preventive means that you are going in to talk about preventing new issues and not treating any form of disease, sickness, or pain. Disease, sickness, or pain falls under diagnostic. Doctors make more money by telling you to not talk about any sickness or pain and coming back for a second visit than they do by asking if you have any pain. Because insurance companies will pay them for the preventive and then again 3 days later when you come back in to talk about whatever ails you. Nurses and doctors are trained to just ask you certain questions and most don't even understand billing or insurance claims. Hell, I used to have to explain to doctors how their own insurance works by breaking it down as simple as I would for you and the same as for nurses. If your doctor's office is having nurses purposefully convert preventive care to diagnostic then they are idiots, because that could be 2 appointment visits instead of one.
We don’t do well visits, but in the old days (>40 years ago) the PURPOSE of a well visit is the UNCOVER problems. PROBLEM ORIENTED visits have NO TIME to address those creaky shoulders. We spent a lot of time for them, and we developed a comprehensive plan for the future, addressing EVERYTHING we could/should address. But guess what? Speaking and thinking take time. And time is money. And thinking is valuable, as I assume medical personnel are worthy of their wage, as it were. And I believe Clark is WELL COMPENSATED for his thinking and judgement. Is Clark willing to give anyone a low budget financial plan? But not your physician. Ok, lie to him/her, don’t mention the chest pain, the weight loss, the blood in stool, abdominal pain, etc. Save a few bucks. I hope it’s worth what the doc might miss.
The problem is the insurers and to some extent patients devaluing medical service. Insurers do not want to pay for anything and force this false dichotomy on us. This makes us physicians bill more when we assess/discuss/treat more. But the patient expectation is cheap! OK, get Amazon healthcare! Doesn’t that sentence worry you? Sure efficiencies would help. But the hardware and software is very expensive. And you would not believe how many people cannot manage a tablet interface. But to the point, go cheap! Just an oil change. Anyone can do it. Remember, in most venues low bid does not get you quality.
Listening to the medical insurance questions and replies has reinforced my decision as a US citizen to get a medic alert bracelet that says, "If found down, confused or nonresponsive, don't help me. Leave me by the side of the road to die. I can't afford to get well."
💔💔💔
Where can we get one? (Seriously)
That's the correct approach.
That's the reality for many people in this country
Airlines are getting as bad as insurance companies.
re: airline tix...price it both ways....in my market to NYC , one way $164 and RT=$189. So, RT works for me in my market. Takes just a minute to check both ways, one way may work for certain markets. I use google flights price tracking which alerts me to changes automatically thru email ,it's a terrific assistant and saves me on fare expenses
Great tip, Clarkie! 🙌
Is the google ‘flights price tracking’ what you use for specific flights. I heard about a google search which shows cheapest fares to different destinations. I can’t remember the wording used to find those fares.
What I think is going on is they have changed the term from 'Annual Physical' to 'Annual Wellness Visit'. I, too, have found myself saving up some issues to cover during my Physical, only to find my doctor getting annoyed with the 2nd or 3rd thing and saying, 'you really should be scheduling a separate appointment for this.' I blame the insurance companies.
As a healthcare provider, I have worked in the health insurance industry and at a hospital. You have to think of visiting your doctor like going to a restaurant. If you only order what’s on the menu, you won’t get charged extra. Any modifications then you will get charged extra. Also, healthcare providers and hospitals want to turn over patients just like a restaurant wants to turn over tables. they will get paid more with more patients/customers they see. It’s terrible but healthcare is a business, and anyone thinks differently has not been in the industry long enough. If your local hospital seems like it’s always under construction, ask where the money comes from.
Good analogy! 🙌
Yep! Everyone wants to complain but nobody wants to change it. They always talk about us RNs “working at the top of our license” but don’t give us the independence to do so. We are stuck doing the MAs and CNAs job. 🫤
Your analogy would be better if you include that when going to the restaurant you get served water or bread, things you assume are complimentary, only to see the bill and noticed you are being cahrged. Thats called a surprised bill and more and more medical facilties are resorting to this to fatten up their bottom line. Its a busineess like you said and nowdays money is more important than medical care. Can't wait for AI to disrupt the entire medical industry.
In a restaurant you get the prices on the menu . In healthcare you do not. I have this issue now with Kaiser. Also, Kaiser is billing me 5 times the amount that I could get in other facility. Do not plan to pay Kaiser
@@JorgeDiaz-fr6qjAI is only going to streamline things more. AI will NOT improve personaluzed care. Just the opposite.
I travel a lot for work and have been for years. I have NEVER seen it where a 1-way ticket price is cheaper than RT. 1-way is almost always double the price of a RT ticket. This is true whether it is a domestic or international flight.
Not true, used to be RT was trip.
@@rejaneroe9531 Can't understand you. Are you tripping?. "RT was trip".
Not true at all. For all my travel i have never bought a rt. Two one-way gives you way more flexibility and the best deal, unless you are booking a one-way during an event in the city you are leaving or visiting.
I agree with deejay, every single time I have tried to book 2 one way , it is always way more than the roung trip . Airlines are such a rip off these days I don't even want to fly
Wrong
23:59 billing is completely unethical now. For my annual, or almost any other visit, anything over 15 minutes, they charge for 2 visits. So I’d still have my co-pay (under old plan). I’m in Dayton, OH and that’s how the two big companies do it (they’ve bought many providers - almost all family care). My NP tells me that she shouldn’t give away her time - I agree, but also she’s not getting that $$. (She is 1000% worth every dime). What’s crazy is I go to my endocrinologist, in a Cincinnati hospital practice and am billed LESS. I get on a soapbox about this stuff; it’s truly criminal in between the insurance companies, big Pharma, and now our local health conglomerates.
Talk to RFK office.
Truth
I fly a lot now and I have been buying one way tickets for the last several years. The reason is because it IS cheaper. BUT you need to be able to be flexible, so I look at what dates have the cheapest flights and I'll try to fly on those days either coming or going.
Also, I have also stopped using any other method to book tickets such as Expedia or whatever for the specific reason that if you have a problem with your flight, the airlines can't help you. And you have to go through that third party and it doesn't always work out very well.
My sister-in-law went to Europe like that and something went wrong and she was stuck in whatever city was her layover and ended up spending 24 hours stuck there/ having to get a hotel and missed out on a full day where she was going because she had a third party ticket.
There's my 2¢!
I still use Expedia and it’s okay if nothing goes wrong. When things have gone wrong, things have usually worked out pretty well.
I always fly really cheap.
I’ve found one ways to be more expensive at times, as well as booking on the site.
I always fly different airlines on each leg though, whichever works best for me on that flight.
I’ve done that for decades.
Thank you for your 2 🪙
@@spinnettdesigns Good input. I actually just spent a couple hours today with my friend who wanted to fly from Minneapolis (where we live) to Florida end of Dec to early Jan.
Of course over the holidays prices are way more expensive and her round trip flight was going to be $800 plus.
I suggested that we look at 2 one-way flights and was looking them up and checking different airports to see what would be cheaper because I have a place in Fort Myers and I could pick her up at Tampa or Miami or Orlando and drive her to her friends (where I would stay overnight too because I know her friend).
I found her a $219 flight TO Orlando and a $194 flight back FROM Orlando. (Orlando was definitely the least expensive airport out of about 5 major airports that i checked)
So with her checked baggage and paying for some seats, her price out-the-door was $500 so she literally saved $300.
I know sometimes it is better to do the round trip but I always check it and it usually works out to be better one way but that's also probably because I have the flexibility and I choose my dates according to what's the cheapest.
There's my 2¢!!! 😁
@ thats 4 cents now 😂
I’ve traveled a lot and k know what you mean…
It’s easier for me bc I never check baggage and I’m my own boss, so I’m flexible, and that makes it WAY easier.
I helped a friend save a similar amount in October, going from San Diego to New England. Rental car too…but we did it on Expedia!
Thank you for your thoughts, they are appreciated.
@@spinnettdesigns Ah, now you have me thinking I should double check those other options! 😁
It's a good thought as things change for sure. 👋
Even Kaiser physicians don’t look at your medical records before your visit . Nurses still ask the same questions like what meds you take . They simply don’t have time when the brass wants 20 patients or more a day to be seen.
Makes me mad. They all do that now
I am with Kaiser and agree with most complaints about them. That said the medication questions are needed as we often change what is prescribed and what we actually take. This gives them a chance to get the record in sync. Especially when it comes to prescriptions that have refills we no longer use.
@@markliechty6434 Yeah, the updating of medications is important each time. It's the nurse asking you the same questions the doctor will ask you (not medications) so that you have to tell your story again, but you leave out some things because you think you just said that (which you did) so the doctor does no get the full picture. Also, there have been many times the nurse conveyed inaccurate information to the doctor that I have had to undo. They want to put me in a category that is typical to tell the doctor why I am there. I'm told that the nurse asks those questions so as to be sure the doctor get the full picture, but it ends up confusing the issue instead in my experience. That's why I prepare a short narrative in print for them to say all I want to say so no one can cut me off and so both them and I can have a full record of each visit.
The medications question is necessary since there may be changes, especially when patients see multiple specialists who prescribe. I have seen cases where the question is not asked, with the result that patients are taking incompatible or overlapping drugs, or drugs to treat the side effects of other drugs when it would be simpler to change the original to something that does not produce them.
We are required to update certain categories and your Dr may not get paid if we don’t click the box!
Regarding unexpected charges at an annual-physical visit: the medical practice I go to now goes over that with me at check-in (sbd earlier). The intake form has two sections. Part 1 explains what's covered in the exam. Part 2 asks if I'll also want to bring up new concerns, reveals that those will be separately billed, and wants my go/no-go decision and a signature. Evidently, though, any updates or questions about conditions already under the doctor's care are not subject to additional cost. This can be individual and will depend on the terms of each person's contracted medical insurance plan. - At least, though, the practice I use reveals everything up front.
Love the transparent disclosures! 💚
That's a great, ethical practice!
18:33 i’m with you, Clarke! I still can’t believe they’re pushing paper. I’m almost 50 and went to the OB/GYN and they gave me a clipboard to update my information and I had to fill it out and it was on paper. How stupid and a waste of resources!
My doc told me that anything not related to the normal annual exam would / could require a separate appointment. I took that as extra on the annual exam bill too. And that they are under a time frame per patient, I believe it was 15 minutes. It was never like this before.
It's good that your doctor is communicating the operational change. Many are not, and patients are getting surprised bills. 💚
That is absolute bullshit, this is the way it has been billed for many years. If you bring up a sickness, you are billed for a sick office visit as the diagnosis code differs from the preventive care billing. There is absolutely nothing that has changed in recent years. I have been out on disability for 4.5 years and going back almost ten years before that, when we processed claims we processed by the diagnosis codes. The diagnosis code explains why you are there. If you think you can go in under a preventive care appointment and get treatment, and have the insurance company pay for it as preventive you are asking the doctor to commit insurance fraud. If you are getting treatment, you are sick; if you are sick, then you are not there for preventive care. If you want one free appointment a year, then book 2 separate appointments on two different days, and don't talk about aches pains, or sicknesses during your "Free Appointment". When I worked for the insurance company it was policy to inform members to not talk about anything during the preventative because it would change it to a diagnostic. My doctor 20 years ago used to tell me about this too, and I would laugh at them because I processed claims for the insurance company. I would tell them, that it will cost me more $$$ to take off time from work to do two appointments than it will if we just book an appointment for both things on the same day. This is nothing new and there is NO SCAM going on, if you are sick that doesn't qualify as a preventive care visit. A preventive care visit is just that a preventive care visit.
@@RiverWoods111 So what exactly can we do at the preventive visit? Can we request blood work to be done? Can we go to walk-in clinic and request it to be a preventive care visit? A few times I called my Doctors to schedule one, they'd always tell me that the first available for it is weeks or months later.
I had a problem with a leg muscle and went to an orthopedist. I mentioned a sore knee the I thought could be related and the clerk (not a medical professional) snapped at me “well you need a separate appointment for that.” I had Covid and because of my age didn’t want to fool around. I went to what I thought was an urgent care place where I wasn’t tested but was told to go buy a test and if it was positive call them and they’ll call in a prescription. The PA didn’t even examine me. I got a bill for a new patient visit. They called the prescription in to the wrong pharmacy a day later and it was going to cost over $400. I left it there. People wonder why I avoid interacting with the medical establishment. I can only imagine how frustrating it is for doctors to find themselves subordinate to the bean counters.
There are several so called concierge doctors in my area. Cut out insurance and get unlimited access to your doctor. The kevel of access and care is amazing for a small monthly membership fee
Say more? Like where you live, name of concierge?
The monthly fee is NOT small, and any lab work, tests, hospital charges will fully be on the patient. It isn’t a feasible replacement for insurance unfortunately
@@RootBound505 completely right, not a replacement for insurance to cover bigger things. Fees in my area for these types of practices seem to be $75-200ish monthly, dependent on age and practice.
@@noahj.5740 $6000 annually for the only one in my area
With all the medical coding shenanigans I am thinking of completing a medical coding program and working as a patient advocate.
I bought a brand new 2007 Hyundai Accent with 25 miles, it now has 398,000 miles and still running well. So much cheeper to fix than buy a new car.
Facts. The fact that people buy a new car every 2-3 years is insane. What is even more insane is leading unless your company gives you a car credit as compensation. Them if you aren’t paying for it who cares
This happens 100% of the time in my area- thay then bill the insurance company for the physical and an office visit for the additional complaints you had (such as the shoulder popping ) then you have to pay your co-pay. . This has happened to me for the past 15years.
That is why when you sign the consent to treat- it says you are responsible for any charges not covered
I have insurance through my employer, and we are told during orientation each year when we renew the plan that for your annual physical, you cannot ask any other questions or you will be charged. The other thing I seen was about changing of the coding we will also told by our employer if you go in for your preventative colonoscopy if anything up or anything shows up then it changes from just your preventative one to one you have to pay more for.
The mystery that is the YT algorithm sent you my way and I’m glad it did! New subscriber, thanks YT!
At my urging, my 30 year old son went to a PCP to establish care and have an annual checkup. His insurance covers preventative services. The Dr. examined him and ordered bloodwork, all standard stuff. He was charged over $300 for the Dr. visit and the lab work. When he called the insurance company, they said he had to ask the Dr. to change the way it was coded. When he called the Dr., he was told that they couldn't change it because this was a first time visit, which makes absolutely no sense. If the Dr. won't change it, what else can he do? He paid the bill, but says he is never going back to that Dr.
Sadly that happens alot. Your son should fight it. The medical scare is fukn scam nowadays. My friend had similar issue.he called every where and got it removed. And posted online. And filled complaints.
That's bs! Ask to speak to the manager at the billing department and if they refuse then tell them you don't want to have to give them a bad review
Same happened to me, and I used to work in health insurance. Only the doc can change it. They double bill even with all the regulations and get away with it.
It’s not the doc. The government set it up this way. My husband is a retired physician, and said that if you go in for your annual physical and mention a problem that you want the doc to check out, the preventative visit becomes an office visit, and you are then charged for it. That’s a simple example, but there are other factors. It’s probably best in this day and time to clear this up before you are seen by your physician.
@@JJ-ur9yp
So the office I have been using for thirty years tried that on me. So the next time I went in. I stopped my doctor and told him that this was my free checkup and to not speak to me about anything that was not covered
We Canadians have been using video healthcare since the Pandemic started. It is a great way to cut down on the backlog in the healthcare system and I am a huge fan. Of course there are always times when you need an actual in person examination but I think it’s a great way for them to see more people efficiently. Great video by the way. Thanks!
Who are you using for international travel insurance?
I have never had this. I go to a doctor who is HCA provider, every physical she ask how I am doing. We talk about all kinds of things going on, I have never been charged an extra fee.
“Do no harm” should apply to financial health along with physical health.
They changed the Hippocratic oath approx 20 yrs ago, from, do no harm, to, do the least harm.
Our health systems in the USA are broken. And they are broken because of the ill-conceived notion of medical insurance. Insurance companies are in business to make money. And, these days, it's very competitive. The insurance companies cannot afford to cover people without these sinister practices.(and still make a profit)
I think insurance companies should make a pact to cover an individual for life, not just year to year. Then they'd be sure to assist parents in ensuring kids get proper nutrition and exercise.
Great point.
We need a revolution to change medical billing, people are getting sick and afraid of the bill
We need a single payer system for all and regulation of all forms of insurance.
24:00 EVERY TIME I go for a physical, they find some way to bill for things that are not covered under the free physical scope. How have you not encountered this?
That was happening to my husband. I called and found out they were billing him each year for a recheck of blood work, and not scheduling and billing his free physical. Now when we make the appt we make sure that it is scheduled as a physical.
It appears to be common practice now. Check out these comments. 💚
There is no point to go to a doctor for a "well care" annual visit that just gives them an opportunity to prescribe drugs.
I have a blood pressure monitor, glucose monitor, scale etc etc plus I order my own blood work and monitor my own health.
And push vaccines
The fastest way to get sick, is start going to the Dr's office lol. Seriously, they will find something that isn't perfect, according to them, pre diabetes, slightly high BP, Cholesterol, something. Then once you start the pills, forget it. Unless you have a reason to go, don't. Breast exams etc are good, but the regular physicals, bad news.
At both my care providers in the US, the office had disclaimers on all the forms, website, and in the office warning that if the patient asks any questions about perceived ailments, the charges will be billed as diagnostic.
Love the transparent disclosures! 💚
I've done this for two years. It wasn't for financial reasons, but for scheduling freedom. But I have come out either cheaper than roundtrip, or at least in the same ballpark.
Regarding the bone density test, you should appeal the decision!
First, discuss vigorously with the office, as administrative errors happen, that it’s a diagnostic test, obviously. Second, appeal to the insurance that its diagnostic, no previous condition exists, and urge the importance of the insurance company saving money by paying for the preventative care rather than paying for the disease care.
Insurance companies also make erroneous clerical decisions.
They do charge for questions during the dr vist if it is annual vist
I always said America practice is Rockefeller medicine this is one example of many
My doctors office is doing the same thing. A family member went for a sports physical that we paid cash for and got a receipt. My wife asked a question and are now being billed $317.. About a month after the visit we received a bill for the $25 we had already paid. Called and they said it was a mistake we didn’t owe anything. Then about 3 1/2 months later we received another bill for the $317. The charges are:
$25 we already paid for the sports physical
$12.97 pure tone screening ( what ever that is)
$25.94 visual screen Quantitative B
$253.14 OV Est Pt level III (what ever that is)
Talking to these people is like talking to the wall. The last conversation they said they would bill our insurance for the charges.
Aye yai yai 🥴 Hope they are able to sort this out for you soon. 💚
Pure tone is a hearing test. Some insurances do not cover a hearing or vision test as a preventative service and some insurances do. Level III is the minimum level of service a physician performs. That means your condition that was treated that day was a minimally complex problem with few or no tests, labs, studies, or reports to review. Also the treatment was minor such as prescribing an over the counter medication, treatment, or additional new tests. Or the total time it took to cover your assessment and documentation was a minimum of 20 minutes. So…level III is how a physician documents and bills their time, much how a lawyer bills for their time. You probably only paid $25 for the paperwork entailed in the sports physical and now the other part of the physician assessment. Btw there are no diagnostic codes for sports physicals. So if an physician tries to get reimbursed for their work from the insurance company and says the patient was seen for sports physicals, the claim will be denied because it is not attached to a valid diagnostic code and the physician would have done all that work for free and never have been paid.
That being said, if you paid cash for the whole visit up front, they should have been more transparenta about which additional services you were paying for. We tell people when they request additional hearing, vision tests, etc that the insurance may not cover those services during an annual physical
Every single time I ask for a receipt for the co-pay of $25, later I get a bill for $25. Then I called the office and they tell me to ignore the bill. Note that the receipt never has the date or what the receipt was for. So now my husband and I write the date and what was done at that visit because it’s so easy to forget. But this has happened at least five times in the last six months.
@@TudorCityGrrrl was it a receipt or an EOB (explanation of benefits)? They can look almost exactly the same.
I haven't traveled abroad in a few years but I found many places did not want to accept a credit card (this was Croatia). Any small, under 10 Euro purchases and they were quite displeased.
That should tell us something about how the global financial corporations are ripping off small businesses everywhere. That’s why they strongly prefer cash.
Big difference between business credit and corporate credit. Business uses your social corporate uses your run number. Be sure to build corporate and don’t confuse the two
Thank you for this information. I just did a check and indeed it's cheaper to buy one way.
What a coincidence! I actually bought a 2013 Hyundai Accent used several years ago partly because that model had a great maintenance track record. I've been very happy with it... It's up over 100,000 miles now...
I just did this less than 7 days ago. It BACKFIRED on me. I ended up paying MORE than if I had just booked the roundtrip. I used Southwest, booked the tickets on different browsers, and I was *not* signed in. The 2nd browser is an anonymous browser.
Does amazon health do prior authirizations for prescriptions or no?
So for the Amazon video plan.... is that your only cost? Or you have to pay for visits etc. is it insurance or just assigning a dr?
On a wellness visit, they checked my thyroid and billed me another visit on the SAME DAY. My insurance paid for all of it.
Wait you buy a one way there and one way back ?
Possibly different airline ?
During a physical when the dr asks how i am feeling, i just say fine and have learned to NEVER bring up any medical issue he does not bring up first. They have and continue to charge extra for that. Same with diagnostics. Colonoscopy is deemed preventative and covered 100%, UNLESS they find something. Then it is switched to diagnostic and NOT covered by insurance. I've had several different companies that bill this way. It's a racket.
My one way flight Paris to Miami was the same price as round trip. I cruised to Europe and didn't need round trip.
Clarks Christmas kids sounds amazing. I lost my job so I cannot contribute but I will pass along the information .
How to get high deductible insurance for emergency
I am 63 healthy just need a insurance policy for only emergency purposes
Did one way flight to Jamaica in June. Saved $400.00
Great info. Thanks!
All things being equal buying a car under business enables you to walk away from a car loan without damaging your own personal credit, which is more critical for mortgage etc. In this case your cat loan is under your llc you don't even need to declare your car loan in a mortgage application.
I was actually wondering about this the other day.
Sadly that is how it works woth annual physical. There is a checklist of items that nurse and doctor go through for a wellness check or annual checkup. Ive had that happen and doctor says Ill need to make another appointment tondiscuss thst matter sonce this is a annual physical exam.
I usually use Google Flights for finding which flights I want, then I go to the individual airlines to book.
How does the one medical work with insurance? Or does it?
They accept all of the major insurance providers for membership services. If you elect to do pay-per-visit, it's self-pay only but is FSA/HSA eligible. 💚
I’m waiting for a drone to come by and take my vital signs 😜
I purchased a new 2004 Hyundai Accident. Drove it for 16yrs, 216,000 miles.
Great car!
Hyundai Accident? 😢
@@laulaja-7186 LOL!
the Annual Physical ideally should be dedicated to updating mammograms, colonoscopies, vaccines, screening for vision or hearing loss. Also discussing healthy diet, benefits of exercise, use of sunscreen, sexual health and STD prevention, importance of good quality sleep, stress management, etc. Doctors are often criticized for not focusing on wellness and instead benefitting from disease/illness and pushing prescriptions. This is our once yearly opportunity to plan how to keep patients as healthy as possible.
THE RADIATION FROM ANNUAL MAMMOGRAMS RAISE THE CHANCE OF GETTING CANCER. DOC TOLD MY MOM DECADES AGO. JUST A HUGE CASH COW LIKE EVERYTHING ELSE! A PATIENT CURED IS A PATIENT LOST. THINK!
Thank you for all the great information. I recently consulted with an attorney regarding a will and estate planning. Their fees seemed especially high for my needs. But, in part of the consult, one of the items that was included was a health care POA that was stored online. We would receive a card with access data so medical professionals could see it online. This seems like a great idea. But, I can't locate anything like that online. Are you aware of anything like this?
Clark & Team - You are misinformed regarding additional questions at “Annual Physicals. Unfortunately, if a patient asks questions OUTSIDE the scope of what is generally covered, you can be billed at the “re-established” visit code. Translation - additional costs. Same situation happened to me! Even involving my insurance, the office refused to revise the billing code.
What does the asterisk beside some of the timestamp chapters signify?
In many instances, when traveling internationally, you don't have the option of NOT BUYING a round trip ticket! Governments in the places you travel to INSIST that you have a round trip ticket, or they won't let you into the country!
beware - some rental car companies in some locations require a return ticket at the time of pickup.
You blew the preventive physical exam question. This is a Well Visit and per coding guidelines if additional problems are addressed that are "significant, separately identifiable, medically necessary, and reasonable to treat illness, injury, or improve functioning of malformed body part" can be billed in addition to the well visit. The staff should have asked when rooming the patient if he had any new concerns and inforn there would be an office visit charge. The patient can then decide if he wants to discuss these concerns and pay for this extra service or come in another day to discuss these problems. The provider was saving the patient having to make another appointment having to take more time out of his schedule, but the patient should have been informed.
While as a healthcare consumer (only) who has run into this situation, IMO "blew [it]" is a bit harsh given they were speaking generally about public perception.
Anec-data: A bit over a year ago I was approaching one of those decade ages and ahead of my annual physical I increased (from a low baseline) my exercise. To show it's appreciation, one of my knees self-destructed about 2 weeks before my scheduled appointment. Fortunately I had observed the signs in the exam room during previous year's physicals that indicated any health issues raised during an annual physical would be treated as a separate visit, so I called my provider and changed the nature of my existing appointment and had them book my physical for another few weeks later. Ironically (or paradoxically?), during the annual exam she asked about my knee, possibly as it was an established part of my medical history/known condition (or whatever).
So, yeah, the American healthcare system is great, as long as your goal is to overpay for worse outcomes and feel terrible while doing it!
🦨 #clarkstinks Thanks for your feedback! No one on Team Clark is a medical professional, so we're answering questions based on what seems fair from the average patients' perspective.
Historically, asking questions while you were already in the doctor's office did not incur additional coding and charges. If that is standard verbiage at most doctor's offices now, this needs to be communicated to the patients - outside of the 12-page terms and conditions that most people don't read. When someone asks to take a look at a shoulder pain in a routine visit, the doctor or nurse should say, "We'd be happy to take a look at that! Just so you know, it will be an additional charge." This way, patients can decide if they want the doctor to take a look at it or not. 💚
@@Clark in Massachusetts this changed for me about 5 years ago. Any discussion you bring up turns is considered a separate office visit. And charged as such.
Recently my doctor's office put up signs saying that any medical questions outside of the scope of the initial visit COULD BE charged separately. That was not the case with annual check-ups in the past. If the point is patient care and prevention, answering a few 30 second casual questions, during an annual update, could save trouble down the road and lead to far better patient outcomes. Treating every question as a billable event is silly, for most health maintenance questions. I wouldn't expect free treatment for a broken ankle at an annual physical, but if I've been a tad sluggish as I age, I wouldn't expect a bill for the doctor to suggest a morning exercise or two. So far, my doctor's office hasn't billed for anything but the physical. But I also now ask, hypothetically, the billing question - if I will get a charge for the category of question, before I actually ask it. If they ever said yes, I wouldn't ask, and I would check out Dr. Google instead. That's where mad billing will lead. And most folks won't be looking for peer-reviewed journal articles from respectable publications, they'll just try crazy internet suggestions.
That is the dumbest thing I ever heard. A normal preventative checkup is to go over any concerns. That is the point. You are supposed to bring up any pains or issues as part of preventative care investigation otherwise it is not a normal preventative checkup.
I guess I'm driving for free also. I have a 2006 Toyota Highlander what's 226,000 Miles. I get all the oil changes on time at the dealership which I buy a package deal at and the oil changes cost about $20 more than at a Jiffy ... Plus I get 100 point inspection list which tells me which things need attention especially scheduled maintenance. I think this is why it's lasted so long because the previous owner did the same.😊
Oh no same happens at my doctor office. They no longer do an annual check up.
They literally do a well baby on an adult eyes, ears, nose and throat and you’re out of there!🤯
Love this guy and his lady friend. Great information on buying airline tickets. I like to go right to the airline website and look at the calendar for the daily prices. It's funny for a Tuesday maybe 79 dollars and the next day will be 159 dollars
Have you checked which USD to Euro exchange method is better : bank (debit card) with no foreign transaction fees or Revolute/ WYse alternative ?
so if i buy 2 one-way tickets on separate airlines and there’s a “major schedule change” on one which breaks my trip then im out the money for the other ticket 😮
I wonder if 1-way will find you a later flight for free if space is available if you "miss" (for whatever reason, you don't have to say) your flight like they do with rt tickets? Would make sense if they did. You really already paid for your ticket...you just missed that particular flight.
I received a text from my OB/GYN stating the list of questions. I am allowed to ask while I am there, and a list of questions that are not covered by medical Medicare. What shocks me is that the whole idea of going to that type of doctor is to care for the list of questions that are not covered by Medicare. It is shocking, it is absolutely shocking, shocking, shocking, so please know that there are many of us that are experiencing this. Please please Clark address this matter please please we need your help
I’ve been doing one way tickets for the past few years! way more options
just need to check baggage policies these days 💯
please tell us about one way tickets to Europe
Do you have to have a primary medical insurance plan?
No, you don't need insurance. You can opt for self-pay. In fact, if you're using pay-per-visit, they don't accept insurance for this service (membership visits can be billed to insurance). Pay-per-visit is FSA/HSA eligible. 💚
Just did annual wellness DR appt - 3rd yr this DR. What was new -- 2pg form to sign before the appt - spelling out what was wellness visit. My guess, the goal to stop wasting everyone's time when the billing hits & the angry calls begin for an explanation and to dispute the charges. For me previous 2 years had to call DR office for recoding so that insurance would reverse the charge. For me it was 100% wellness. As I say to them: just here for the gatekeeper to provide order fo annual screening blood lab. My gripe -- why insurance requires DR order vs just go directly to the lab. If lab result shows something out of range, then makes sense to have a DR appt.
One of our Clarkies told us about a company called Own Your Labs. It's a website where consumers can order labs directly, without a doctor's order. Team Clark has not checked it out yet, but it may be something you'd want to look into. 💚
ownyourlabs.com/
I feel like I could have flown halfway across the country in the time it took him to finally get to the simple point (two one way tickets might be cheaper than one round trip).
M. D . VIP is also good but very expensive. I paid $1800 for that service for one year. Crazy
I got bit by the diagnostic vs screening scam. I had the insurance rep and the provider rep on a 3 way and the provider insisted that they could not legally change it to screening. I think it was total BS, but who knows. Anyway I had to end up paying myself.
If during an annual physical/preventative exam, if a separate problem was discussed ( like a bad headache. finger pain/ shortness of breath, Blood pressure issues'- the provider will have to bill for 'preventative 'visit and also for the 'acute visit/diagnostic issues'. They will not be able to change the code.
Google flights show separate airline options...just saying
Why does clark have TWO WATCHES ON??
Clark, you left out another MAJOR reason for not buying round-trip tickets. Airlines apply a methodology called "married segment logic". How this affects you is that if you buy a round trip ticket let's say from point A to point B and from point B back to point A. Now, one of the legs is now cheaper so you call the airline and say that you want the difference back. They say "wait just a minute cowboy, not so fast.". Before we can refund the difference we have to REPRICE the entire trip first. This will likely reprice your round trip ticket higher negating any savings from the one leg that is now lower in price. When you price a round trip itinerary, the airline is pricing two one-way fares to begin with.
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Great show 😊
Not always the case , sometimes round trip is lower than one way or about same.
💯 Always best to compare both and take the best deal.
I do one way searches because I like to price it both ways in both dollars and miles.
How about a traveling to Europe do you book both ways or one-way travel?
I thought AIR ambulance wasn't covered by the No Surprises Act. I'll have to take another look.
Air ambulance is typically covered, although ground ambulance is generally not covered. A small number of states have enacted laws to protect against surprise bills for ground ambulance services. 💚
I have great success with consolidators. Like any professional service, you need a good one.
They do Healthcare better almost everywhere else in the world. But here in the USA, we are married to capitalism, so money takes precedence over people. We aren't smart enough to research Healthcare in other countries and model that because we couldn't dare admit someone else does something better than the USA. My sister in Australia got a knee replacement for $200. Dr visits are a small copay and all meds are paid for. Her husband has dementia and he's in a nursing home. It's all paid for. They take care of their people in Australia. Her taxes are not terribly high, and she does not wait a long time to see Dr's, nor is she receiving sub standard care. We are being lied to so a few people in the United States can be mega rich while the rest of us struggle.
Welcome back!!
The problem with buying 1 way tickets is you risk losing money on 1 if flight is cancelled going and not coming back. So don't make sense
You go to a preventative medical visit and the doctor says "I see your number for [chronic condition such as hypertension or diabetes] has changed and so we'll adjust your medication, an additional "code" is added and there is an additional charge because this is now diagnostic. Legitimate or not?
Unfortunately, legitimate, but we don't like it. Seems like this is the standard way doctors are conducting business now. 💚
If your doctor wants to change the medication- You will need to let doctor know- not to address those and that you will come back another day, to discuss those important issues. Then there will not be additional code/charges
You’d think airlines would charge less for round trip because thats sort of “buying in bulk”
Clark. When traveling overseas DOES NOT WORK. As you said.
I have to disagree with Clark on squeezing all the inefficiencies out of medical practices. It has gotten to where doctors and other medical workers are more concerned about following corporate policies, checking boxes, being cognisant of legal ramifications, and using AI to diagnose rather than listen to the patient fully as an individual, a person not fitting into the typical conclusions. I can tell that my doctors are frustrated with their EPIC programs they are forced to use. Then, of course, there are the insurance companies also telling the doctor how to do their work and what they should do. No wonder so many doctors are leaving the field and many bright young people are steering clear of the field. We all suffer because of it. And then there are all those who can't even afford health care at all. Our system is a mess and technology and efficiencies are not the answer!
Good points! 💚
#BonusTerm - #WelcomeBack Team Clark. Glad you're back, enjoying the show. #TeamClarkRocks
💚 #bonusterm
Comment based solely on the title of the video: Booking a one-way ticket is a surefire way to get the dreaded SSSS on your boarding pass. Why would you sign up for extra, invasive security checks?
I wish I were allowed to "interpret" Federal regulations.
Can you use one medical overseas?
Whaaat they don't just pierce a corporate veil... There has to be a court ordered reason. There is absolutely a better advantage for buying the car through business if she is 100% using it for business.
Can you get a pap smear from Amazon?
Play at 1.5 speed. You're welcome
I a-l-w-a-y-s do that, no matter what the video.
Be careful what site you buy your tickets from! Scammers are everywhere
💯💯💯
Clark, there are older adults that are not tech savvy. Great for you that you are tech savvy, but please consider others who are not when making blanket statements about the practice of still using paper.
tell lady w old car:j change cabin filter (do it yourself...look in manual. buy at parts store.$30. Engine air filter, too. easy !!! Put in new battery. Parts store can READ battery. tell you three readings, how its doing. Batteries have gone up in price. It just is.
Third party drama and prepaid restrictions is a problem.
As a physician I will let you know that a physical exam is for preventative screening. Any specific concerns that are not preventative screening are considered a “problem visit.” Aka “hey doc, I have this problem I would like you to fix.” If you are getting a physical you don’t pay for the preventative part of the evaluation that day. You do pay for the chronic/acute problem you want us to assess. We commonly tell people that if you have a problem you want addressed you will pay for it. I’ve worked in places where it is on a sign at the desk or a document you sign acknowledging this. That applies to all insurance across the board. If you have insurance that doesn’t require you to pay for problem visits (ie., Medicaid) you probably never noticed the doctors office was billing the insurance company the whole time for that.
For the woman with the bone density scan bill. She should address that with the radiologist or owner of the bone density scan 95% of the time her primary care doctor does not own the machine and does NONE of the billing for tests. All handled by a third party. Contact the radiologist or hospital first. Then call your doctor.
Very useful information in todays healthcare world. Thanks!
Thanks for sharing your medical expert knowledge! 💚
Can you help me with this question please: If I don't take any routine meds, I'm not sure what the point is of having an annual physical. I can check my weight, temp, B/P at home by myself, and that's about all that is done these days for an annual physical, if I can't ask what a new minor acute problem is, I'm not sure what the point of the annual is other than to have my doctor review blood results, and I don't need an office visit for this process.
@ I will not give specific medical advise. But, I will answer your question generically. Depending on your age you may be due for certain cancer screening (ie colon, prostate). You may be due for certain vaccines based on age. Or other lab testing to ensure you are still healthy ( cholesterol, diabetes, etc). I still recommend patients come for a physical once per year. Every day I have the unfortunate task of diagnosing someone with a surprise new condition like high cholesterol or diabetes. That evaluation should be free with insurance. You can still see your doctor for acute concerns. It’s just not typically covered 100% by insurance.
Exactly why I left the insurance backed primary Dr practices. My first visit with a direct billing practice was 90 minutes face time with the doctor. Actually get the care and consultation I need to proactively take charge of my health.