My favorite is when the insurance company doesn't pay because the charges
are not 'reasonable and customary'. Then the doctors office wants me to
pay. Well...if the experts at the insurance company have decided that they
aren't 'reasonable or customary', why should I have to pay the difference???
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Heard:
The "expert" at the insurance company is an 18 year old with NO medical
experience. Ask them what they mean and they'll tell you that they surveyed
x number of doctors in some small town as to what they were charging which
has no relationship to the city you are in. Then they decided "that" was
R&C. It is used to veil the fact that the patient is not paying enough
premium to get the service they think they deserve. It's amazing how so many
people "know" that insurance companies are out to screw everyone but when
it's their dental or medical insurance they miraculously become saints. R&C
is merely a way to con the patient into thinking the small benefit they
negotiated with their employer (for a small premium) was a good deal. In
insurance and car repair if you pay little, you get little. I often have
patients who pay the big premium and get 100% of my fee regardless of what
that is. That is insurance. Dental insurance has never been designed to
cover the full cost of care, merely supplement it. Don't get me going on why
medical insurance is sky high because then we get into illegal immigration.
Anyway, why would you want to go to a doctor whose skills were only
"reasonable and customary" ie average? Do you want the neurosurgeon that got
"C"s?
Not me.
Ron Davies
SoCal
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