New Plan-Layaway Pathology

[LADoc00]

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After encountering numerous non-payments, I have new healthcare model, at least for pathology...Layaway.

Basically, like layaway when your mom was trying to buy a new sofa when you were a kid, patients have their biopsy and make installments against the fee for the read. When they are paid in full, a report is issued. Each month they get a notice saying how much they owe and an ominious message "It may be negative...but it might be cancer!"

Im looking to check the legality of this now. Anyone else know of path group doing this? I know many oral surgeons, optho and plastics types have installment plans and I want to go this route.

 

[yaah]

Yeah you could say that a panel of immunostains would help the diagnosis be more accurate, and you could get a package deal going, like one stain for $100, but 10 for $500.

I think the only way you could do it would be for consults. You could even provide levels of service. Like, an extra amount of money will get you personal time with the pathologist who will go over your diagnosis with you. Extra money of course would also provide a more thorough report.

Level I: Cancer vs benign
Level II: What type of cancer
Level III: Complete morphologic description
Level IV: Factors in prognostic variables and immunostains for prognosis (Her2Neu, etc)
Level V: Attaches references with explainers. report comes with a glossy color picture of your cancer so you can put it on your wall and entertain guests.

All levels of course get an autographed copy of the report.

 

[Aubrey]

If you're not satisfied with your diagnosis, the next one's free.

 

[DarksideAllstar]

Yeah you could say that a panel of immunostains would help the diagnosis be more accurate, and you could get a package deal going, like one stain for $100, but 10 for $500.

I think the only way you could do it would be for consults. You could even provide levels of service. Like, an extra amount of money will get you personal time with the pathologist who will go over your diagnosis with you. Extra money of course would also provide a more thorough report.

Level I: Cancer vs benign
Level II: What type of cancer
Level III: Complete morphologic description
Level IV: Factors in prognostic variables and immunostains for prognosis (Her2Neu, etc)
Level V: Attaches references with explainers. report comes with a glossy color picture of your cancer so you can put it on your wall and entertain guests.

All levels of course get an autographed copy of the report.

I like this schematic, but I think it should be amended. Level II and III should be switched, if only because after describing mrophology to a clinician once I was asked "But its still endometrial right?" They would definitely pay more for knowing the type and that way they could go through their treatment plan algorithm.

This seems like a great idea to me, although some may not live long enough to pay for a Level V report via lay-away.

 

[deschutes]

This thread deserves to be printed and pasted on the wall of the residents' room.

 

[Gut Shot]

After encountering numerous non-payments,

Who has been giving you the bone? Insurance? Patients? Both? Other?

 

[LADoc00]

Who has been giving you the bone? Insurance? Patients? Both? Other?

Medical insurance is a big problem, there are like a dozen different plans, only some of which will pay me so its crap shoot.
The state of California in general is very slow to pay in general. Docs dont realize it can take several months to get a medical provider # but patients can get a medical card in a day with phony social security cards so just starting out you can snagged providing tons of medical service for free (!) until your provider # is issued. Absurd of course. I have taken to weeding all outpatient medical specimens out and sending them back. Its really my only option.

The other source is private payers who get the bill decide they dont want to pay it and send you a sob story as to why they are currently broke. Some of it is hilarious, I read em. Others you are like "Damn I know this guy and he owns a flipping S500 Benz"! So basically people try to BS you big time. I send em to collections basically.

Still others will put themselves on some payment plan and send you 5 bucks a month on a $500 bill. Absurd. I write back "Yeahhhh about this 5 bucks a month plan, No, No..."

 

[Gut Shot]

Medical insurance is a big problem, there are like a dozen different plans, only some of which will pay me so its crap shoot.
The state of California in general is very slow to pay in general. Docs dont realize it can take several months to get a medical provider # but patients can get a medical card in a day with phony social security cards so just starting out you can snagged providing tons of medical service for free (!) until your provider # is issued. Absurd of course. I have taken to weeding all outpatient medical specimens out and sending them back. Its really my only option.

Ah yes. The same old story I've been hearing time and again. I'd wager that tort reform is small potatoes compared to the potential benefits of fixing this highly deranged system of reimbursement. The insurance companies should be forced to pay in a timely fashion, according to contract, and be accountable for any little "errors" that occur along the way. You'd think the Gubbmint would be salivating over the prospect of fining private health insurance companies for such infractions. Somebody call Eliot Spitzer.

Kinda makes cash-only up-front seem appealing. Histotech carries less than $20 in change.

 

[djmd]

If you're not satisfied with your diagnosis, the next one's free.

Your diagnosis is less than 30 stains or its free.*

Offer not valid on Flow or Soft-tissue.

 

[PathOne]

Tips to rake in more $$$$:

1. Charge more for a descriptive diagnosis. Actually once did a frozen, where the surgeon (a non-native speaker btw) had a problem with the word "benign". Since then, I would say "it's cancer, and it's DEADLY", if that was indeed the dx. That should bring entitlement to a "translational fee".

2. Expand your patient population. Why limit yourself to getting consults on other physcians patients only? Once did a biopsy for a "Dermatologist-to-the-stars". It was from one of his most cherished patients: His dog. Imagine the income potential, if you start dx'ing non-humans too!!!

 

[djmd]

Tips to rake in more $$$$:

1. Charge more for a descriptive diagnosis. Actually once did a frozen, where the surgeon (a non-native speaker btw) had a problem with the word "benign". Since then, I would say "it's cancer, and it's DEADLY", if that was indeed the dx. That should bring entitlement to a "translational fee".

I always said that we should begin charging surgeons for frozen sections, just like 5-10 bucks mind you. Because we do too many (and many are not clinically indicated). I mean hell you know the patient gets billed for these 'just curious' FS. It might avoid these "we want to know while we are in the OR, but we will have closed the patient before you call back" cases could be avoided.
You know the surgeons don't care enough to pay five bucks.

Also you could charge a few for every interaction like this:
Pathologist: "Need any more frozens tonight?"
Surgeon: "yeah, a margarita"

ha ha, funny once. Funny a hundred times? no.
Path: "I'll just add the "using tired joke" fee to your tab, Dr. Surgeon-man."

 

[LADoc00]

His dog. Imagine the income potential, if you start dx'ing non-humans too!!!

Hey keep that on the down low! If Ameripath or US LABS gets wind of the vet path market potential my future biz plan is sunk....seriously, there is one last goldmine out there....

 

[yaah]

There's probably a very lucrative market out there for canine lab tests too for people who either think their precious is deficient of some vital nutrient or being poisoned.