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July 27, 2004

MonkeyFace™


Yes, thats me. Monkey adam. I have been embroiled in a battle between my teeth and the dentists which I am caught in the middle of. It began with a simple dental visit, but something was wrong with my upper gum. They didn't understand why. What they did know is that it was caused by that time I was hit by a baseball when I was in 5th grade. I lost half my front tooth in that incident and had a root canal the decade before last. There were multiple appointments in which I had a new root canal and lots of cleanings. Finally, yesterday morning, I went to an Endotontist for dental surgery. They opened my gums and did 2 bone graphs inside the tooth that had the root canal so long ago. It was a painful procedure and it will take days to heal. They will remove the stitches on Monday.

The worst part of all of this is how it exposes the new insurance racket and how that has negatively affected me in terms of money. I've written before (1,2,3) about our general health care woes, but its always bad when it happens to you. In the past, you went to a doctor, who found out whether you had insurance, did the work and billed your insurance company. That insurance company paid the doctor his/her due, then collected the difference they wouldn't cover, from you. Well, it appears as though insurance companies felt they were getting a raw deal. After all. they are paid tons of money to do almost nothing, clearly they are not being paid enough to collect the money as well. So the rules have changed in many instances. Now, the all powerful insurance behemoths are telling the Doctors the process should go like this: Your doctor performs his/her work, then bills your insurance company for the full amount. That insurance company sends them only the portion that insurance company was going to pay, minus your part. That leaves the doctor with the task of collecting the rest directly from you? Most doctors have private practices and can't afford never to get paid, nor do they have collection systems in place like the insurance companies. So they're response is to bill you the full amount at the time they do their work. That leaves the responsibility of collecting the patients money from the insurance company with the patient. To some degree the patient has always had to collect their portion, but now they have to argue what is their portion and collect everything. In the past, it was the other way around. The insurance company, who could afford to have you owe them money until they figured out how much you owed them, has relinquished that responsibility. Now they owe you money. For me, that was over a grand and I'm pissed. All I can say is, go see The Corporation. Its only going to get worse.

Posted by wonko at July 27, 2004 10:33 AM

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