Apparently I am not the only one confused about physician tiering…
January 8, 2012 in Health Insurance, Insurance Bills, Member Stories
I thought I would relay the following story, as it perfectly illustrates how confusing the physician ratings are to consumers.
Recently I was seeing one of my 7 year-old patients who was sick with a cold. His mother asked me if we could combine his sick visit with his upcoming medication check because her co-pay had recently increased to $50. After expressing that she would not be able to bring her children in as often as she would like due to the high cost, she reassured me that she did not want to leave my practice as I had known her three children since birth. She explained that she was glad that her insurance company valued me so highly that they could charge such a large co-pay!
I couldn’t help it, I burst out laughing. Her interpretation of expensive co-pays was the exact opposite of what was intended by her insurance company. And unfortunately for her family, it was making health care less accessible, while not driving her to find a practice with a lower co-pay (one that her insurance deemed more cost effective). She did express that if and when it was possible she would be switching insurances to one that had more affordable co-pays.
After a lighthearted conversation about physician tiering, I was able to see her child for his sick visit and his medication check. Luckily, she did not down-grade her opinion of my medical skills based on this new information and I will continue to care for her children for years to come.
Martha Bebinger said on January 8, 2012
Funny Sarah – what do you think about being the Nieman Marcus of pediatricians??