[zaidf]

I have a question that I think about a lot and for most part, have not found an answer that makes logical sense.

Why do insurance companies play such hardball with compensating private practices or medical groups? It would seem like it is in the interest of insurance companies for private practices to flourish given that the same thing done at a hospital costs the insurance companies 3-6 times more money.

Most doctors that I ask this question suggest there is a conspiracy where insurance companies are in bed with hospital. Frankly, I don't buy it. I'm probably missing something and I'd love to hear someone's take who has thought about these issues deeply as you clearly have.

[dave48]

The insurance companies pay long after we see the patient and most of them play about the same games. So, either we don't take any insurance (which would drastically reduce most of our incomes) or we just learn to play their games.

For the record, my wife has gotten pretty good with the billing so I usually get paid for what I do. At first it was very painful because dealing with insurance companies has a steep learning curve in the beginning, but it's not so bad now.

It's still highly inefficient billing each insurance company for each separate patient I see just to collect the amount most people pay to fill the gas tank of their car but, that's hardly the worst problem with health care in this Country.

[zaidf]

Why do you think insurance companies play this game if it is not in their interest? I would think they would want private practices to flourish so their patients reduce use of hospitals and in the end, save the insurance company money.

[dave48]

Again, no doctor turns away a patient who has insurance that he takes. Insurance contracts are signed by doctors years in advance. Insurance companies learned long ago that they can get away with being obnoxious as long as they're not so obnoxious that doctors would drop them. They walk that line rather well.

[zaidf]

Got it, and I agree that insurance companies walk the line rather well in getting doctors to accept them.

But at a macro level, don't you think the insurance companies have failed themselves given rise in private practices closing shop or being bought out resulting in insurance companies needing to pay a lot more to hospitals?