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Thread: what a shitty week.

  1. #41
    Senior Member
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    Quote Originally Posted by Sue Pendleton View Post
    Umm, I believe the ADA specifically disallows rejected patients due to disability. They can't pre-screen over the phone or refuse you as a patient as long as you meet their insurance requirements and most have to take you if they accept Medicare assignments. "Complicated" cannot be used as code for "disabled".

    http://www.ada.gov/medcare_mobility_ta/medcare_ta.htm
    Its not about whether the office is accessible to treat patients or not Sue.

    You fill out a detailed medical history, they request your records and you wait to see if they want to treat you.

    It has nothing to do with insurance either. They can deny treatment of any patient they want to in the office setting.

    In the hospital setting, Medicare does come into play. They cannot deny you treatment in a hospital emergency room because of a whole litany of regulations.

    There is no regulation anywhere that states a doctor must see a Medicare/Medicare Advantage Insurance patient even if the doctor accepts the insurance.

    I began seeing this trend in 2000 in the 24 bed hospital located in a very desirable "retirement destination". My last rural hospital where I kept minutes for the medical staff, I asked. Rural communities like where Jody lives is mainly college kids and older people. There is not much in between with really good insurance. In a populated area, the middle makes up for the ends in insurance payments. So physicians are more apt to take sicker patients.

    This is what is known as the bell curve. If you picture your people with insurance making up the biggest curve of your profits then the ends of the curve should be the elderly and young people without insurance. In rural areas the bell curve is skewed in that they don't have enough people with insurance to make up the lost profits for people with Medicare and Medicaid.

    In 2009, there was a program where the physicians could receive extra funding for each complicated diabetic patient they managed. It was close to a reservation and studies shown that the diabetics were not getting the treatment they needed. So there was a program for extra funding for rural doctors to take and manage the more complicated diabetics.

    I called 20 doctors when I relocated to another state. None of them would see me unless I sent them my medical records first and they reviewed them to see if they would accept me. The others ruled me out "over the phone" just by the medications that I took at the time.

    It is a huge part of the reason I now live in a bigger city. I went through 3 General Practitioners here before finding one.

    Medicare rules and regulations change daily so some of this may have changed since my last chat with the rural doctors I knew.
    T12-L2; Burst fracture L1: Incomplete walking with AFO's and cane since 1989

    My goal in life is to be as good of a person my dog already thinks I am. ~Author Unknown

  2. #42
    Senior Member
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    May 2006
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    Somewhere in the Rocky Mountains
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    For further information on patient dumping: Google the "no duty rule"

    In essence, if the physician never establishes a patient/physician relationship he has no duty to treat.

    Interesting article here:
    http://www.physicianspractice.com/pa...oblem-patients

    http://www.physiciansnews.com/2002/0...eat-a-patient/

    If the physician sees you in an emergency room, then the relationship has been established.

    They can avoid the ADA by simply saying "I feel the patient requires more specialized treatment than I can provide at this time".
    T12-L2; Burst fracture L1: Incomplete walking with AFO's and cane since 1989

    My goal in life is to be as good of a person my dog already thinks I am. ~Author Unknown

  3. #43
    Quote Originally Posted by jody View Post
    thanx wahwah,....... I like my Dr, she is a good Dr.

    Heya jody, no worries. you sounded down and depressed, hope our comments have cheered you up!
    "The problem with self improvement is knowing when to quit." "Diamond" David Lee Roth.

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