Saving Your Life for $59.04
Valuing Your Health at Wal-Mart
I went on the Wal-Mart web site recently. I personally have never been in a Wal-Mart. This is not for economic reasons because in my family paying retail is a mortal sin. It is only because there is no Wal-Mart anywhere near my house. From what I have been told by people who work in my office who do live near a Wal-Mart is that the value of your purchase is amazing. You can get anything at the lowest rate. Quality items. Good American products. I decided to test this.
I drove up north and went into Wal-Mart in Newburgh, NY. By Google Map directions this is a 1 hour and 19 minute ride. When I walked in I went to the information counter and a very nice woman named Sherry was there to assist me:
Sherry: "Hello, Welcome to Wal-Mart, can I help you."
Dr. K.: "Yes, Sherry, I am looking for some basic items for my life."
Sherry: "Oh, that is no problem, we stock a huge inventory here at Wal-Mart."
Dr. K.: "That's great Sherry, but I am on a budget."
Sherry: "Well, Sir, you certainly came to the right place. At Wal-Mart your dollar really goes a long way."
Dr. K.: "Excellent. Here is what I need. I need "an office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: an expanded problem focused history - an expanded problem focused examination - medical decision making of low complexity. Counseling and coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity.
Sherry: "Oh. Well according to our catalog, that is a 99213."
Dr. K.: "Bingo, Sherry."
Sherry: "Are there any other items you need besides that?"
Dr. K: "Well, not right now. After the 99213 I may need to get some more things like a 74182."
Sherry: "Why, you are a very knowledgeable consumer. A 74182 is an abdominal MRI. Currently we have these in stock. We were running this as a Web special but some people had resolution problems with their monitors."
Dr. K.: "I know- I was in the neighborhood anyway so I figured I'd pick it up some things from your Recommended Gift List."
Sherry: "That's fine. What is your budget?"
Dr. K.: "Well, I am on Medicare and I have been allotted $59.04 for a 99213. I assume that you accept assignment on Medicare?"
Sherry: "Let me get the manager."
Manager: "Sherry tells me you are interested in our 99213, is that correct?"
Dr. K.: "Yes it is. I am looking for a 99213 for my chronic diabetes complicated by kidney failure. I have my Medicare card so you can be reimbursed $59.04 for this complete management."
Manager: "Well, Sir, we do have an ample supply of tremendous quality of domestic and imported 99213s but since we would be out of business if we gave such a product at $59.04. We opted out of all government programs."
Dr. K.: "That's outrageous. Healthcare is a right! You must give me my 99213 for $59.04. It is in the Constitution and the Declaration of Independence (maybe not in that order)."
Security: Come with us sir...
So what is continued management of your diabetes and kidney failure actually worth by Wal-Mart standards? Let's go to their Web site:
Gifts Making the Must-Have List
Based on this, the things that I must have total: $2316.64
Based on the fact that if my doctor could not control my runaway train diabetes and my kidney failure for $59.04 I would not be able to even consider getting these MUST-HAVE items. This makes the treatment of these terrible life-threatening diseases by a medical professional who was in school for about 3.65 million years worth the following:
59.04/2316.64 or 2% of the value of these items. So using the #1 retailer in America as my source, the MUST-HAVE gift items are 50 times more valuable than my health.
Maybe I can ask Sherry at Wal-Mart if I don't have to pay the co-pay since I took up so much of my valuable time waiting to shop there by being in the car for the drive.
Dr. K.
Glossary of Terms:
99213- This is the code for a follow exam used by Medicare and all insurance companies. The code is part of a book the size of Mt. McKinley called CPT: Current Procedural Terminology, copyright AMA. All events in a medical office are "coded." There is a fee associated with these codes. Doctors in the Medicare system (pretty much all doctors) are required by law to accept the fee determined by Medicare. The example I used 99213 is actually a proper code for a follow-up visit for a patient with chronic diabetes and kidney problems. The $59.04 is the actual fee the physician gets paid for any and all time and effort involved in this encounter. Even if you treat the billionairre Warren Buffet, if he has Medicare you will have the grand opportunity to collect $59.04. In 2006, Congress determined this was excessive and lowered it 4.5%. That should either balance the budget completely or purchase more time at Scores (a gentleman's club) for Congressmen and their lobbyists.
Sherry- a sweet liquor. I really did not meet a person named Sherry. I need to put this in on the off chance that there actually is a clerk at Wal-Mart named Sherry. If that was the case (and according to Murphy's law it is) then she would promptly get a lawyer and sue me. Another great American tradition. I would then have to pay her considerably more than $59.04. She would probably be able to buy the Must Have list for the entire eastern seaboard. Her lawyer, of course, would get 33% of that. That is a lot of plasma TVs for one person.
I went on the Wal-Mart web site recently. I personally have never been in a Wal-Mart. This is not for economic reasons because in my family paying retail is a mortal sin. It is only because there is no Wal-Mart anywhere near my house. From what I have been told by people who work in my office who do live near a Wal-Mart is that the value of your purchase is amazing. You can get anything at the lowest rate. Quality items. Good American products. I decided to test this.
I drove up north and went into Wal-Mart in Newburgh, NY. By Google Map directions this is a 1 hour and 19 minute ride. When I walked in I went to the information counter and a very nice woman named Sherry was there to assist me:
Sherry: "Hello, Welcome to Wal-Mart, can I help you."
Dr. K.: "Yes, Sherry, I am looking for some basic items for my life."
Sherry: "Oh, that is no problem, we stock a huge inventory here at Wal-Mart."
Dr. K.: "That's great Sherry, but I am on a budget."
Sherry: "Well, Sir, you certainly came to the right place. At Wal-Mart your dollar really goes a long way."
Dr. K.: "Excellent. Here is what I need. I need "an office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: an expanded problem focused history - an expanded problem focused examination - medical decision making of low complexity. Counseling and coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity.
Sherry: "Oh. Well according to our catalog, that is a 99213."
Dr. K.: "Bingo, Sherry."
Sherry: "Are there any other items you need besides that?"
Dr. K: "Well, not right now. After the 99213 I may need to get some more things like a 74182."
Sherry: "Why, you are a very knowledgeable consumer. A 74182 is an abdominal MRI. Currently we have these in stock. We were running this as a Web special but some people had resolution problems with their monitors."
Dr. K.: "I know- I was in the neighborhood anyway so I figured I'd pick it up some things from your Recommended Gift List."
Sherry: "That's fine. What is your budget?"
Dr. K.: "Well, I am on Medicare and I have been allotted $59.04 for a 99213. I assume that you accept assignment on Medicare?"
Sherry: "Let me get the manager."
Manager: "Sherry tells me you are interested in our 99213, is that correct?"
Dr. K.: "Yes it is. I am looking for a 99213 for my chronic diabetes complicated by kidney failure. I have my Medicare card so you can be reimbursed $59.04 for this complete management."
Manager: "Well, Sir, we do have an ample supply of tremendous quality of domestic and imported 99213s but since we would be out of business if we gave such a product at $59.04. We opted out of all government programs."
Dr. K.: "That's outrageous. Healthcare is a right! You must give me my 99213 for $59.04. It is in the Constitution and the Declaration of Independence (maybe not in that order)."
Security: Come with us sir...
So what is continued management of your diabetes and kidney failure actually worth by Wal-Mart standards? Let's go to their Web site:
- Plasma Screen TV: $1698.00
- MP3 Player: $208.82
- Kodak Digital Camera: $209.88
- 10' Portable DVD player: $199.94
Gifts Making the Must-Have List
Based on this, the things that I must have total: $2316.64
Based on the fact that if my doctor could not control my runaway train diabetes and my kidney failure for $59.04 I would not be able to even consider getting these MUST-HAVE items. This makes the treatment of these terrible life-threatening diseases by a medical professional who was in school for about 3.65 million years worth the following:
59.04/2316.64 or 2% of the value of these items. So using the #1 retailer in America as my source, the MUST-HAVE gift items are 50 times more valuable than my health.
Maybe I can ask Sherry at Wal-Mart if I don't have to pay the co-pay since I took up so much of my valuable time waiting to shop there by being in the car for the drive.
Dr. K.
Glossary of Terms:
99213- This is the code for a follow exam used by Medicare and all insurance companies. The code is part of a book the size of Mt. McKinley called CPT: Current Procedural Terminology, copyright AMA. All events in a medical office are "coded." There is a fee associated with these codes. Doctors in the Medicare system (pretty much all doctors) are required by law to accept the fee determined by Medicare. The example I used 99213 is actually a proper code for a follow-up visit for a patient with chronic diabetes and kidney problems. The $59.04 is the actual fee the physician gets paid for any and all time and effort involved in this encounter. Even if you treat the billionairre Warren Buffet, if he has Medicare you will have the grand opportunity to collect $59.04. In 2006, Congress determined this was excessive and lowered it 4.5%. That should either balance the budget completely or purchase more time at Scores (a gentleman's club) for Congressmen and their lobbyists.
Sherry- a sweet liquor. I really did not meet a person named Sherry. I need to put this in on the off chance that there actually is a clerk at Wal-Mart named Sherry. If that was the case (and according to Murphy's law it is) then she would promptly get a lawyer and sue me. Another great American tradition. I would then have to pay her considerably more than $59.04. She would probably be able to buy the Must Have list for the entire eastern seaboard. Her lawyer, of course, would get 33% of that. That is a lot of plasma TVs for one person.
6 Comments:
YOU GO DOC !!!!!!!!! Very few people, including, or maybe especially, our great elected officials, have a CLUE as to what is going on. The few who know, are making millions- greed and politics-sad state of affairs. Great post- just wish the public knew what was going on behind their backs- especially with the new "Medicare Part-D" rx coverage- what a JOKE- on our senior citizens to boot.
I thought I was doing the responsible thing by having insurance through my husband (which, laughingly, is through Target!). I went to see my doc because I had bruising and bleeding for a few weeks and had blood work done. I was in the hospital the next day with a preliminary diagnosis of leukemia (which later was clarified to Acute Promeyelocytic leukemia). I expressed my concern at the cost of the hospital stay to the hospital who said they contacted my insurance. They said my insurance claimed they would pay for everything 100% except for 2500.00. I thought that was too good to be true and I was right. THEY were going to pay the 2500.00. I had to pay the rest. We are talking hundreds of thousands of dollars in diagnostic testing and hospital stay in the first month! Also my prescription coverage was only 500 dollars a year and my medicine was 5600.00 a month! So of course you would think having cancer I could get some help but oh no! In my state (florida) you have to be declared disabled in order to get medicaid. To be declared disabled I couldn't work more than 20 hours a week. So I could work part time and NOT pay my household bills or I could work full time and NOT pay my medical bills. It has been the most frustrating part of the illness has been trying to get adequate medical coverage!
Gee Whillikers Doc,
Is it possible someone that maybe someone is a fearful of some competition? Yea, I know, if they had wanted to be Doctors they should have gone to medical school.
Relax, I know third party and lawyers no longer treat you medicos like gods anymore-but at least you still have the nursing profession to put back in their place when they "get uppity".
My husband had back surgery in December then hip surgery in March... all from the same accedent that happend at work. A week ago a doctor called my husband into his office on a Saturday since he could not reach us on Friday to inform us that he had fround that he has Acute Renal Failure of his Kidneys. We were told the doctor to see. We made an appointment, before we could go they called us and said we could not be seen because we had no insurance and of course Work Comp would not pay for it. I have been doing reseach myself and the cause of this matches what he has gone thru. The good news the doctor did give us was that when he gets really sick he can go to the emergancy and be seen then possibly be put on the donor list!!!! I hate that everything is all about money!!
Thank you Doctor for the info, I learned of cpt coding recently and was told for Multiple Sclerosis and Intravenous steroids would help.
Well according to the cpt code of 90765 it will cost approx. $89 a unit and each outpatient visit (three suggested) the fee for using the hospital visit could be anywhere from $150-$450 each visit.
Keep in mind I am without insurance at this time, while in pain I continue to work 40 hours a week. I am caught between a wall and a hardrock when it comes to applying for social security because they say you can not gross more than $900 monthly, well how will I continue to pay my bills(rent, car insurance medical bills, food)while waiting for the approval of social security. People who are actually trying to help themselves receive no help.
Thanks for the info Doctor. I recently found out what a cpt code was when it was suggested I have three sessions of intravenous steroids for Multiple Sclerosis at Approx $89 a unit (1gm), and the outpatient fee for facility use $150-$450 each visit. Keep in mind I am without insurance at this time.I applied for social Security however I'd pretty much need to cut my working hours in 1/2 which I need to do but then who would pay the rent, buy the food,pay medical bills, light bill, etc. in order to apply for social security a person can not gross more than $900 monthly.I do not get it there are people out here who have worked all of their lives and when they need help to access the money they worked to build up (social security) they can't get. Wow sweet America!
Post a Comment